Data Exchange For Quality Measures Implementation Guide
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Data Exchange For Quality Measures Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 4.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-deqm/ and changes regularly. See the Directory of published versions

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 QI Core Organization Profile QI Core Organization
Patient QI Core Patient Profile QI Core Patient
Practitioner QI Core Practitioner Profile QI Core 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\"><p class=\"res-header-id\"><b>Generated Narrative: Library library-mrp-example</b></p><a name=\"library-mrp-example\"> </a><a name=\"hclibrary-mrp-example\"> </a><a name=\"hclibrary-mrp-example-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p></div><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/STU5/StructureDefinition-qicore-patient.html\">QICore Patient</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/STU5/StructureDefinition-qicore-encounter.html\">QICore Encounter</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/STU5/StructureDefinition-qicore-location.html\">QICore Location</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/STU5/StructureDefinition-qicore-task.html\">QICore Task</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=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</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=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-practitioner.html\">QICore Practitioner</a>)</td></tr></table></div>"
  },
  "url" : "http://hl7.org/fhir/us/davinci-deqm/Library/library-mrp-example",
  "version" : "4.0.0",
  "name" : "DEQMLibraryMRPExample",
  "title" : "DEQM Library MRP Example",
  "status" : "active",
  "type" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/library-type",
      "code" : "module-definition"
    }]
  },
  "date" : "2024-07-01T03:32:44+00:00",
  "publisher" : "HL7 International / Clinical Quality Information",
  "contact" : [{
    "telecom" : [{
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/cqi"
    }]
  }],
  "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/qicore/StructureDefinition/qicore-organization"]
  },
  {
    "type" : "Practitioner",
    "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"]
  }]
}

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://hl7.org/fhir/CodeSystem/task-code",
          "code" : "fulfill",
          "display" : "Fulfill the focal request"
        }]
      },
      "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/qicore/StructureDefinition/qicore-practitioner"]
      },
      "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/qicore/StructureDefinition/qicore-coverage"]
      },
      "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"]
      },
      "identifier" : [{
        "use" : "temp",
        "system" : "http://exampleoflocation.com",
        "value" : "DaVinciClinic01"
      }],
      "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/qicore/StructureDefinition/qicore-organization"]
      },
      "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/qicore/StructureDefinition/qicore-organization"]
      },
      "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/qicore/StructureDefinition/qicore-organization"]
      },
      "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://terminology.hl7.org/CodeSystem/observation-category",
          "code" : "exam",
          "display" : "Exam"
        }]
      }],
      "code" : {
        "coding" : [{
          "system" : "http://www.ama-assn.org/go/cpt",
          "code" : "1111F",
          "display" : "Discharge medications reconciled with the current medication list in outpatient medical record (COA) (GER)"
        }]
      },
      "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/qicore/StructureDefinition/qicore-practitioner"]
      },
      "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/qicore/StructureDefinition/qicore-coverage"]
      },
      "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"]
      },
      "identifier" : [{
        "use" : "temp",
        "system" : "http://exampleoflocation.com",
        "value" : "DaVinciClinic01"
      }],
      "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/qicore/StructureDefinition/qicore-organization"]
      },
      "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/qicore/StructureDefinition/qicore-organization"]
      },
      "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/qicore/StructureDefinition/qicore-organization"]
      },
      "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" : "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" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MeasureReport_97e6dbd2-17f1-11ea-82fa-4ccc6a181ed3\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MeasureReport 97e6dbd2-17f1-11ea-82fa-4ccc6a181ed3</b></p><a name=\"97e6dbd2-17f1-11ea-82fa-4ccc6a181ed3\"> </a><a name=\"hc97e6dbd2-17f1-11ea-82fa-4ccc6a181ed3\"> </a><a name=\"hc97e6dbd2-17f1-11ea-82fa-4ccc6a181ed3-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-indv-measurereport-deqm.html\">DEQM Individual MeasureReport Profile</a></p></div><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"Measure-measure-mrp-example.html\">MRP Measure</a></p><p><b>subject</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-6f0cef31-2235-4d66-82e2-fa861fc909a8\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:44+0000</a></p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-ebc3f5c4-6700-34af-8323-85621c313726\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:44+0000</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><blockquote><p><b>id</b></p>initial-population</blockquote><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><blockquote><p><b>id</b></p>numerator</blockquote><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><blockquote><p><b>id</b></p>denominator</blockquote><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=\"Bundle-single-indv-mrp-task-report.html#urn-uuid-97e702cc-17f1-11ea-8b65-4ccc6a181ed3\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:16+0000</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\"><a name=\"Task_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Task </b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-task.html\">QICore Task</a></p></div><p><b>identifier</b>: <code>http://example.org/fhir/</code>/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://hl7.org/fhir/CodeSystem/task-code fulfill}\">Fulfill the focal request</span></p><p><b>for</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-6f0cef31-2235-4d66-82e2-fa861fc909a8\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:44+0000</a></p><p><b>encounter</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-1f33ae07-0891-4c2a-a376-fcd18800cb71\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:44+0000</a></p><p><b>executionPeriod</b>: 2017-06-11 --&gt; 2017-06-11</p><p><b>authoredOn</b>: 2018-09-25 14:24:23+0000</p><p><b>owner</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-0000016d-235f-39b3-0000-0000000000fa\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:44+0000</a></p></div>"
      },
      "identifier" : [{
        "system" : "http://example.org/fhir/",
        "value" : "19009"
      }],
      "status" : "completed",
      "intent" : "plan",
      "priority" : "routine",
      "code" : {
        "coding" : [{
          "system" : "http://hl7.org/fhir/CodeSystem/task-code",
          "code" : "fulfill",
          "display" : "Fulfill the focal request"
        }]
      },
      "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/qicore/StructureDefinition/qicore-coverage"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage </b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-coverage.html\">QICore Coverage</a></p></div><p><b>status</b>: active</p><p><b>policyHolder</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-6f0cef31-2235-4d66-82e2-fa861fc909a8\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:44+0000</a></p><p><b>subscriber</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-6f0cef31-2235-4d66-82e2-fa861fc909a8\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:44+0000</a></p><p><b>subscriberId</b>: A123456789</p><p><b>beneficiary</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-6f0cef31-2235-4d66-82e2-fa861fc909a8\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:44+0000</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=\"Bundle-single-indv-mrp-task-report.html#urn-uuid-97e750b7-17f1-11ea-b4af-4ccc6a181ed3\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:16+0000</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/qicore/StructureDefinition/qicore-organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization </b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Tax ID number/456789124\u00a0(use:\u00a0official,\u00a0)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type 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/qicore/StructureDefinition/qicore-organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization </b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Tax ID number/456789125\u00a0(use:\u00a0official,\u00a0)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type 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/qicore/StructureDefinition/qicore-patient"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient </b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-patient.html\">QICore Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Debbie941 McDermott739 (official) female, DoB: 1961-02-26 ( https://github.com/synthetichealth/synthea#0156e3a9-c4e1-4c0a-a53e-03ce3984ac65)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Known Marital status of Patient\">Marital Status:</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}\">M</span></td><td style=\"background-color: #f3f5da\" title=\"Known multipleBirth status of Patient\">Multiple Birth:</td><td colspan=\"3\">false</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Other Ids (see the one above)\">Other Ids:</td><td colspan=\"3\"><ul><li>Medical Record Number/0156e3a9-c4e1-4c0a-a53e-03ce3984ac65</li><li>Social Security Number/999-61-8566</li><li>Driver's license Number/S99966861</li><li>Passport Number/X52208740X</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Alternate names (see the one above)\">Alt. Name:</td><td colspan=\"3\">Debbie941 Funk324 (maiden)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\"><ul><li>ph: 555-755-4280(home)</li><li>903 Wolff Ville Westfield MA 01085 US </li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Language spoken\">Language:</td><td colspan=\"3\"><span title=\"Codes:{urn:ietf:bcp:47 pt}\">Portuguese</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.\">US Core Ethnicity Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CDCREC.html#CDCREC-2186-5\">CDC Race and Ethnicity</a> 2186-5: Not Hispanic or Latino</li><li>text: Not Hispanic or Latino</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"The registered place of birth of the patient. A sytem may use the address.text if they don't store the birthPlace address in discrete elements.\"><a href=\"http://hl7.org/fhir/extensions/5.1.0/StructureDefinition-patient-birthPlace.html\">Patient Birth Place</a></td><td colspan=\"3\">Faro Algarve PT </td></tr><tr><td style=\"background-color: #f3f5da\" title=\"A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc). This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9).\"><a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-birthsex.html\">US Core Birth Sex Extension</a></td><td colspan=\"3\">F</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\n\n - American Indian or Alaska Native\n - Asian\n - Black or African American\n - Native Hawaiian or Other Pacific Islander\n - White.\">US Core Race Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CDCREC.html#CDCREC-2106-3\">CDC Race and Ethnicity</a> 2106-3: White</li><li>text: White</li></ul></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/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" : [{
        "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\"><a name=\"Encounter_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Encounter </b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-encounter.html\">US Core Encounter Profile</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-AMB\">ActCode</a> AMB: ambulatory</p><p><b>type</b>: <span title=\"Codes:{http://www.ama-assn.org/go/cpt 99221}\">Initial hospital care</span></p><p><b>subject</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-6f0cef31-2235-4d66-82e2-fa861fc909a8\">Mrs. Debbie941 McDermott739</a></p><h3>Participants</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Individual</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-0000016d-235f-39b3-0000-0000000000fa\">Dr. Manuel446 Granados71</a></td></tr></table><p><b>period</b>: 1976-06-20 10:41:49-0700 --&gt; 2018-04-29 10:41:49-0700</p><h3>Locations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Location</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-8938e769-59f7-40ff-a541-50b0bfcd6742\">NOBLE HOSPITAL</a></td></tr></table><p><b>serviceProvider</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-ebc3f5c4-6700-34af-8323-85621c313726\">NOBLE HOSPITAL</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 inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded."
        }],
        "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\"><a name=\"Practitioner_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner </b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-practitioner.html\">US Core Practitioner Profile</a></p></div><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.2.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/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\"><a name=\"Organization_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization </b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-organization.html\">US Core Organization Profile</a></p></div><p><b>identifier</b>: Provider number/9999999999\u00a0(use:\u00a0official,\u00a0)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type 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\"><a name=\"Location_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Location </b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-location.html\">US Core Location Profile</a></p></div><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 style=\"display: none\">-</td><td><b>Longitude</b></td><td><b>Latitude</b></td></tr><tr><td style=\"display: none\">*</td><td>-72.755911</td><td>42.138838</td></tr></table><p><b>managingOrganization</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-ebc3f5c4-6700-34af-8323-85621c313726\">NOBLE HOSPITAL</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" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_patient03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient patient03</b></p><a name=\"patient03\"> </a><a name=\"hcpatient03\"> </a><a name=\"hcpatient03-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: versionId: id (PrimitiveType/Patient.meta.versionId): element = id -&gt; versionId=id[4]; Last updated: 2019-02-07 18:47:34+0000; </p><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-patient.html\">QICore Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Virginia Hartman (official) female, DoB: 1983-09-12 ( Medical record number: 34567\u00a0(use:\u00a0usual,\u00a0))</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td>true</td><td style=\"background-color: #f3f5da\" title=\"Known status of Patient\">Deceased:</td><td>false</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Known Marital status of Patient\">Marital Status:</td><td colspan=\"3\"><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-MaritalStatus U}\">unmarried</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\">213 Lilac Ave. Freehold MI 48099 USA (home)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Language spoken\">Language:</td><td colspan=\"3\"><span title=\"Codes:{urn:ietf:bcp:47 en-US}\">English (Region=United States)</span> (preferred)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Patient Links\">Links:</td><td colspan=\"3\"><ul><li>Managing Organization: <a href=\"Organization-organization03.html\">Organization DaVinciHospital03</a></li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.\">US Core Ethnicity Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CDCREC.html#CDCREC-2186-5\">CDC Race and Ethnicity</a> 2186-5: Not Hispanic or Latino</li><li>text: Not Hispanic or Latino</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc). This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9).\"><a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-birthsex.html\">US Core Birth Sex Extension</a></td><td colspan=\"3\">F</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\n\n - American Indian or Alaska Native\n - Asian\n - Black or African American\n - Native Hawaiian or Other Pacific Islander\n - White.\">US Core Race Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CDCREC.html#CDCREC-2054-5\">CDC Race and Ethnicity</a> 2054-5: Black or African American</li><li>text: Black or African American</li></ul></td></tr></table></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" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_patient02\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient patient02</b></p><a name=\"patient02\"> </a><a name=\"hcpatient02\"> </a><a name=\"hcpatient02-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: versionId: id (PrimitiveType/Patient.meta.versionId): element = id -&gt; versionId=id[4]; Last updated: 2019-03-06 19:03:03+0000; </p><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-patient.html\">QICore Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Darien Bernard (official) male, DoB: 1967-06-13 ( Medical record number: 23456\u00a0(use:\u00a0usual,\u00a0))</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td>true</td><td style=\"background-color: #f3f5da\" title=\"Known status of Patient\">Deceased:</td><td>false</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Known Marital status of Patient\">Marital Status:</td><td colspan=\"3\"><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}\">Married</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\">6 Rockwell Street Lynnwood NJ 07420 USA (home)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Language spoken\">Language:</td><td colspan=\"3\"><span title=\"Codes:{urn:ietf:bcp:47 en-US}\">English (Region=United States)</span> (preferred)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Patient Links\">Links:</td><td colspan=\"3\"><ul><li>Managing Organization: <a href=\"Organization-organization02.html\">Organization DaVinciHospital02</a></li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.\">US Core Ethnicity Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CDCREC.html#CDCREC-2186-5\">CDC Race and Ethnicity</a> 2186-5: Not Hispanic or Latino</li><li>text: Not Hispanic or Latino</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc). This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9).\"><a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-birthsex.html\">US Core Birth Sex Extension</a></td><td colspan=\"3\">M</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\n\n - American Indian or Alaska Native\n - Asian\n - Black or African American\n - Native Hawaiian or Other Pacific Islander\n - White.\">US Core Race Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CDCREC.html#CDCREC-2028-9\">CDC Race and Ethnicity</a> 2028-9: Asian</li><li>text: Asian</li></ul></td></tr></table></div>"
      },
      "extension" : [{
        "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" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MeasureReport_indv-measurereport02\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MeasureReport indv-measurereport02</b></p><a name=\"indv-measurereport02\"> </a><a name=\"hcindv-measurereport02\"> </a><a name=\"hcindv-measurereport02-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-indv-measurereport-deqm.html\">DEQM Individual MeasureReport Profile</a></p></div><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"Measure-measure-mrp-example.html\">MRP Measure</a></p><p><b>subject</b>: <a href=\"Patient-patient01.html\">Jairo Webster (official) male, DoB: 1946-12-16 ( Medical record number: 12345\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"Organization-organization01.html\">Organization DaVinciHospital01</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><blockquote><p><b>id</b></p>initial-population</blockquote><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><blockquote><p><b>id</b></p>numerator</blockquote><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><blockquote><p><b>id</b></p>denominator</blockquote><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.html\">Task Fulfill the focal request</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\"><a name=\"Task_task01\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Task task01</b></p><a name=\"task01\"> </a><a name=\"hctask01\"> </a><a name=\"hctask01-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-task.html\">QICore Task</a></p></div><p><b>identifier</b>: <code>http://example.org/tasks</code>/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://hl7.org/fhir/CodeSystem/task-code fulfill}\">Fulfill the focal request</span></p><p><b>for</b>: <a href=\"Patient-patient01.html\">Jairo Webster (official) male, DoB: 1946-12-16 ( Medical record number: 12345\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>encounter</b>: <a href=\"Encounter-encounter01.html\">Encounter: status = finished; class = inpatient encounter (ActCode#IMP); type = Encounter for problem (procedure); period = 2018-05-29 11:00:00-0400 --&gt; 2018-05-29 11:00:00-0400</a></p><p><b>executionPeriod</b>: 2017-06-11 --&gt; 2017-06-11</p><p><b>authoredOn</b>: 2018-09-25 14:24:23+0000</p><p><b>owner</b>: <a href=\"Practitioner-practitioner01.html\">Practitioner Ronald Bone </a></p></div>"
      },
      "identifier" : [{
        "system" : "http://example.org/tasks",
        "value" : "19009"
      }],
      "status" : "completed",
      "intent" : "plan",
      "priority" : "routine",
      "code" : {
        "coding" : [{
          "system" : "http://hl7.org/fhir/CodeSystem/task-code",
          "code" : "fulfill",
          "display" : "Fulfill the focal request"
        }]
      },
      "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\"><a name=\"Encounter_encounter03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Encounter encounter03</b></p><a name=\"encounter03\"> </a><a name=\"hcencounter03\"> </a><a name=\"hcencounter03-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-encounter.html\">QICore Encounter</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-IMP\">ActCode</a> IMP: inpatient encounter</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.html\">Virginia Hartman (official) female, DoB: 1983-09-12 ( Medical record number: 34567\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>period</b>: 2018-05-29 11:00:00-0400 --&gt; 2018-05-29 11:00:00-0400</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>DischargeDisposition</b></td></tr><tr><td style=\"display: none\">*</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" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_patient01\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient patient01</b></p><a name=\"patient01\"> </a><a name=\"hcpatient01\"> </a><a name=\"hcpatient01-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: versionId: id (PrimitiveType/Patient.meta.versionId): element = id -&gt; versionId=id[5]; Last updated: 2019-02-11 14:19:25+0000; </p><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-patient.html\">QICore Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Jairo Webster (official) male, DoB: 1946-12-16 ( Medical record number: 12345\u00a0(use:\u00a0usual,\u00a0))</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td>true</td><td style=\"background-color: #f3f5da\" title=\"Known status of Patient\">Deceased:</td><td>false</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Known Marital status of Patient\">Marital Status:</td><td colspan=\"3\"><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}\">Married</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\">7496 Beaver Ridge Ave Thornton NJ 07003 USA (home)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Language spoken\">Language:</td><td colspan=\"3\"><span title=\"Codes:{urn:ietf:bcp:47 en-US}\">English (Region=United States)</span> (preferred)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Patient Links\">Links:</td><td colspan=\"3\"><ul><li>Managing Organization: <a href=\"Organization-organization01.html\">Organization DaVinciHospital01</a></li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.\">US Core Ethnicity Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CDCREC.html#CDCREC-2186-5\">CDC Race and Ethnicity</a> 2186-5: Not Hispanic or Latino</li><li>text: Not Hispanic or Latino</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc). This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9).\"><a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-birthsex.html\">US Core Birth Sex Extension</a></td><td colspan=\"3\">M</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\n\n - American Indian or Alaska Native\n - Asian\n - Black or African American\n - Native Hawaiian or Other Pacific Islander\n - White.\">US Core Race Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CDCREC.html#CDCREC-2106-3\">CDC Race and Ethnicity</a> 2106-3: White</li><li>text: White</li></ul></td></tr></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"
      }
    },
    "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/qicore/StructureDefinition/qicore-practitioner"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_practitioner01\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner practitioner01</b></p><a name=\"practitioner01\"> </a><a name=\"hcpractitioner01\"> </a><a name=\"hcpractitioner01-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-practitioner.html\">QICore Practitioner</a></p></div><p><b>identifier</b>: Provider number/345678912\u00a0(use:\u00a0official,\u00a0), Provider number/082583\u00a0(use:\u00a0secondary,\u00a0)</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\"><a name=\"Task_task03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Task task03</b></p><a name=\"task03\"> </a><a name=\"hctask03\"> </a><a name=\"hctask03-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-task.html\">QICore Task</a></p></div><p><b>identifier</b>: <code>http://example.org/tasks</code>/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://hl7.org/fhir/CodeSystem/task-code fulfill}\">Fulfill the focal request</span></p><p><b>for</b>: <a href=\"Patient-patient03.html\">Virginia Hartman (official) female, DoB: 1983-09-12 ( Medical record number: 34567\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>encounter</b>: <a href=\"Encounter-encounter03.html\">Encounter: status = finished; class = inpatient encounter (ActCode#IMP); type = Respiratory therapy; period = 2018-05-29 11:00:00-0400 --&gt; 2018-05-29 11:00:00-0400</a></p><p><b>executionPeriod</b>: 2017-08-11 --&gt; 2017-08-11</p><p><b>authoredOn</b>: 2018-09-25 14:24:23+0000</p><p><b>owner</b>: <a href=\"Practitioner-practitioner03.html\">Practitioner Roland Aufderhar(official)</a></p></div>"
      },
      "identifier" : [{
        "system" : "http://example.org/tasks",
        "value" : "19011"
      }],
      "status" : "completed",
      "intent" : "plan",
      "priority" : "routine",
      "code" : {
        "coding" : [{
          "system" : "http://hl7.org/fhir/CodeSystem/task-code",
          "code" : "fulfill",
          "display" : "Fulfill the focal request"
        }]
      },
      "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/qicore/StructureDefinition/qicore-practitioner"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_practitioner02\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner practitioner02</b></p><a name=\"practitioner02\"> </a><a name=\"hcpractitioner02\"> </a><a name=\"hcpractitioner02-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-practitioner.html\">QICore Practitioner</a></p></div><p><b>identifier</b>: Provider number/9998266512\u00a0(use:\u00a0official,\u00a0period:\u00a02005-07-16 09:00:00-0500 --&gt; (ongoing))</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\"><a name=\"Task_task02\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Task task02</b></p><a name=\"task02\"> </a><a name=\"hctask02\"> </a><a name=\"hctask02-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-task.html\">QICore Task</a></p></div><p><b>identifier</b>: <code>http://example.org/tasks</code>/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://hl7.org/fhir/CodeSystem/task-code fulfill}\">Fulfill the focal request</span></p><p><b>for</b>: <a href=\"Patient-patient02.html\">Darien Bernard (official) male, DoB: 1967-06-13 ( Medical record number: 23456\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>encounter</b>: <a href=\"Encounter-encounter02.html\">Encounter: status = finished; class = inpatient encounter (ActCode#IMP); type = Fixation of fracture; period = 2018-05-29 11:00:00-0400 --&gt; 2018-05-29 11:00:00-0400</a></p><p><b>executionPeriod</b>: 2017-06-15 --&gt; 2017-06-17</p><p><b>authoredOn</b>: 2018-09-25 14:24:23+0000</p><p><b>owner</b>: <a href=\"Practitioner-practitioner02.html\">Practitioner Emile Zieme(official)</a></p></div>"
      },
      "identifier" : [{
        "system" : "http://example.org/tasks",
        "value" : "19010"
      }],
      "status" : "completed",
      "intent" : "plan",
      "priority" : "routine",
      "code" : {
        "coding" : [{
          "system" : "http://hl7.org/fhir/CodeSystem/task-code",
          "code" : "fulfill",
          "display" : "Fulfill the focal request"
        }]
      },
      "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" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MeasureReport_indv-measurereport02b\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MeasureReport indv-measurereport02b</b></p><a name=\"indv-measurereport02b\"> </a><a name=\"hcindv-measurereport02b\"> </a><a name=\"hcindv-measurereport02b-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-indv-measurereport-deqm.html\">DEQM Individual MeasureReport Profile</a></p></div><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"Measure-measure-mrp-example.html\">MRP Measure</a></p><p><b>subject</b>: <a href=\"Patient-patient03.html\">Virginia Hartman (official) female, DoB: 1983-09-12 ( Medical record number: 34567\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"Organization-organization01.html\">Organization DaVinciHospital01</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><blockquote><p><b>id</b></p>initial-population</blockquote><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><blockquote><p><b>id</b></p>numerator</blockquote><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><blockquote><p><b>id</b></p>denominator</blockquote><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.html\">Task Fulfill the focal request</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/qicore/StructureDefinition/qicore-organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_organization01\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization organization01</b></p><a name=\"organization01\"> </a><a name=\"hcorganization01\"> </a><a name=\"hcorganization01-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: versionId: id (PrimitiveType/Organization.meta.versionId): element = id -&gt; versionId=id[4]; Last updated: 2019-02-21 01:47:54+0000; </p><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Tax ID number/123456789\u00a0(use:\u00a0official,\u00a0)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type 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\"><a name=\"Encounter_encounter01\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Encounter encounter01</b></p><a name=\"encounter01\"> </a><a name=\"hcencounter01\"> </a><a name=\"hcencounter01-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-encounter.html\">QICore Encounter</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-IMP\">ActCode</a> IMP: inpatient encounter</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.html\">Jairo Webster</a></p><p><b>period</b>: 2018-05-29 11:00:00-0400 --&gt; 2018-05-29 11:00:00-0400</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>DischargeDisposition</b></td></tr><tr><td style=\"display: none\">*</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/qicore/StructureDefinition/qicore-organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_organization02\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization organization02</b></p><a name=\"organization02\"> </a><a name=\"hcorganization02\"> </a><a name=\"hcorganization02-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: versionId: id (PrimitiveType/Organization.meta.versionId): element = id -&gt; versionId=id[3]; Last updated: 2019-03-06 19:03:03+0000; </p><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Tax ID number/234567891\u00a0(use:\u00a0official,\u00a0)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type 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\"><a name=\"Encounter_encounter02\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Encounter encounter02</b></p><a name=\"encounter02\"> </a><a name=\"hcencounter02\"> </a><a name=\"hcencounter02-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-encounter.html\">QICore Encounter</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-IMP\">ActCode</a> IMP: inpatient encounter</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.html\">Darien Bernard (official) male, DoB: 1967-06-13 ( Medical record number: 23456\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>period</b>: 2018-05-29 11:00:00-0400 --&gt; 2018-05-29 11:00:00-0400</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>DischargeDisposition</b></td></tr><tr><td style=\"display: none\">*</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" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MeasureReport_indv-measurereport02a\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MeasureReport indv-measurereport02a</b></p><a name=\"indv-measurereport02a\"> </a><a name=\"hcindv-measurereport02a\"> </a><a name=\"hcindv-measurereport02a-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-indv-measurereport-deqm.html\">DEQM Individual MeasureReport Profile</a></p></div><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"Measure-measure-mrp-example.html\">MRP Measure</a></p><p><b>subject</b>: <a href=\"Patient-patient02.html\">Darien Bernard (official) male, DoB: 1967-06-13 ( Medical record number: 23456\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"Organization-organization01.html\">Organization DaVinciHospital01</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><blockquote><p><b>id</b></p>initial-population</blockquote><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><blockquote><p><b>id</b></p>numerator</blockquote><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><blockquote><p><b>id</b></p>denominator</blockquote><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.html\">Task Fulfill the focal request</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/qicore/StructureDefinition/qicore-organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_organization03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization organization03</b></p><a name=\"organization03\"> </a><a name=\"hcorganization03\"> </a><a name=\"hcorganization03-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: versionId: id (PrimitiveType/Organization.meta.versionId): element = id -&gt; versionId=id[3]; Last updated: 2019-02-21 01:47:53+0000; </p><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Provider number/345678912\u00a0(use:\u00a0official,\u00a0), Provider number/082584\u00a0(use:\u00a0secondary,\u00a0)</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" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MeasureReport_a8f9c686-17f1-11ea-a072-4ccc6a181ed3\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MeasureReport a8f9c686-17f1-11ea-a072-4ccc6a181ed3</b></p><a name=\"a8f9c686-17f1-11ea-a072-4ccc6a181ed3\"> </a><a name=\"hca8f9c686-17f1-11ea-a072-4ccc6a181ed3\"> </a><a name=\"hca8f9c686-17f1-11ea-a072-4ccc6a181ed3-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-indv-measurereport-deqm.html\">DEQM Individual MeasureReport Profile</a></p></div><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"Measure-measure-mrp-example.html\">MRP Measure</a></p><p><b>subject</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-6f0cef31-2235-4d66-82e2-fa861fc909a8\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:44+0000</a></p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-ebc3f5c4-6700-34af-8323-85621c313726\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:44+0000</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><blockquote><p><b>id</b></p>initial-population</blockquote><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><blockquote><p><b>id</b></p>numerator</blockquote><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><blockquote><p><b>id</b></p>denominator</blockquote><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=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-a8fa3b69-17f1-11ea-bd75-4ccc6a181ed3\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:44+0000</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/qicore/StructureDefinition/qicore-coverage"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage </b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-coverage.html\">QICore Coverage</a></p></div><p><b>status</b>: active</p><p><b>policyHolder</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-6f0cef31-2235-4d66-82e2-fa861fc909a8\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:44+0000</a></p><p><b>subscriber</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-6f0cef31-2235-4d66-82e2-fa861fc909a8\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:44+0000</a></p><p><b>subscriberId</b>: A123456789</p><p><b>beneficiary</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-6f0cef31-2235-4d66-82e2-fa861fc909a8\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:44+0000</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=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-a8fa3b68-17f1-11ea-93ae-4ccc6a181ed3\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:44+0000</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/qicore/StructureDefinition/qicore-organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization </b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Tax ID number/456789124\u00a0(use:\u00a0official,\u00a0)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type 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/qicore/StructureDefinition/qicore-organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization </b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Tax ID number/456789125\u00a0(use:\u00a0official,\u00a0)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type 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\"><a name=\"Observation_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation </b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-observation.html\">QICore Observation</a></p></div><p><b>status</b>: final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/observation-category exam}\">Exam</span></p><p><b>code</b>: <span title=\"Codes:{http://www.ama-assn.org/go/cpt 1111F}\">Discharge medications reconciled with the current medication list in outpatient medical record (COA) (GER)</span></p><p><b>subject</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-6f0cef31-2235-4d66-82e2-fa861fc909a8\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:44+0000</a></p><p><b>encounter</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-1f33ae07-0891-4c2a-a376-fcd18800cb71\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:44+0000</a></p><p><b>effective</b>: 2018-09-29 14:15:04+0000</p><p><b>issued</b>: 2018-09-29 14:15:04+0000</p><p><b>performer</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-0000016d-235f-39b3-0000-0000000000fa\">Bundle: type = transaction; timestamp = 2019-12-06 06:28:44+0000</a></p><p><b>value</b>: true</p></div>"
      },
      "status" : "final",
      "category" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
          "code" : "exam",
          "display" : "Exam"
        }]
      }],
      "code" : {
        "coding" : [{
          "system" : "http://www.ama-assn.org/go/cpt",
          "code" : "1111F",
          "display" : "Discharge medications reconciled with the current medication list in outpatient medical record (COA) (GER)"
        }]
      },
      "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/qicore/StructureDefinition/qicore-patient"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient </b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-patient.html\">QICore Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Debbie941 McDermott739 (official) female, DoB: 1961-02-26 ( https://github.com/synthetichealth/synthea#0156e3a9-c4e1-4c0a-a53e-03ce3984ac65)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Known Marital status of Patient\">Marital Status:</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}\">M</span></td><td style=\"background-color: #f3f5da\" title=\"Known multipleBirth status of Patient\">Multiple Birth:</td><td colspan=\"3\">false</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Other Ids (see the one above)\">Other Ids:</td><td colspan=\"3\"><ul><li>Medical Record Number/0156e3a9-c4e1-4c0a-a53e-03ce3984ac65</li><li>Social Security Number/999-61-8566</li><li>Driver's license Number/S99966861</li><li>Passport Number/X52208740X</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Alternate names (see the one above)\">Alt. Name:</td><td colspan=\"3\">Debbie941 Funk324 (maiden)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\"><ul><li>ph: 555-755-4280(home)</li><li>903 Wolff Ville Westfield MA 01085 US </li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Language spoken\">Language:</td><td colspan=\"3\"><span title=\"Codes:{urn:ietf:bcp:47 pt}\">Portuguese</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.\">US Core Ethnicity Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CDCREC.html#CDCREC-2186-5\">CDC Race and Ethnicity</a> 2186-5: Not Hispanic or Latino</li><li>text: Not Hispanic or Latino</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"The registered place of birth of the patient. A sytem may use the address.text if they don't store the birthPlace address in discrete elements.\"><a href=\"http://hl7.org/fhir/extensions/5.1.0/StructureDefinition-patient-birthPlace.html\">Patient Birth Place</a></td><td colspan=\"3\">Faro Algarve PT </td></tr><tr><td style=\"background-color: #f3f5da\" title=\"A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc). This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9).\"><a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-birthsex.html\">US Core Birth Sex Extension</a></td><td colspan=\"3\">F</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\n\n - American Indian or Alaska Native\n - Asian\n - Black or African American\n - Native Hawaiian or Other Pacific Islander\n - White.\">US Core Race Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CDCREC.html#CDCREC-2106-3\">CDC Race and Ethnicity</a> 2106-3: White</li><li>text: White</li></ul></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/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" : [{
        "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/qicore/StructureDefinition/qicore-encounter"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Encounter_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Encounter </b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-encounter.html\">QICore Encounter</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-AMB\">ActCode</a> AMB: ambulatory</p><p><b>type</b>: <span title=\"Codes:{http://www.ama-assn.org/go/cpt 99221}\">Initial hospital care</span></p><p><b>subject</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-6f0cef31-2235-4d66-82e2-fa861fc909a8\">Mrs. Debbie941 McDermott739</a></p><h3>Participants</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Individual</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-0000016d-235f-39b3-0000-0000000000fa\">Dr. Manuel446 Granados71</a></td></tr></table><p><b>period</b>: 1976-06-20 10:41:49-0700 --&gt; 2018-04-29 10:41:49-0700</p><h3>Locations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Location</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-8938e769-59f7-40ff-a541-50b0bfcd6742\">NOBLE HOSPITAL</a></td></tr></table><p><b>serviceProvider</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-ebc3f5c4-6700-34af-8323-85621c313726\">NOBLE HOSPITAL</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 inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded."
        }],
        "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\"><a name=\"Practitioner_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner </b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-practitioner.html\">US Core Practitioner Profile</a></p></div><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.2.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/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\"><a name=\"Organization_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization </b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-organization.html\">US Core Organization Profile</a></p></div><p><b>identifier</b>: Provider number/9999999999\u00a0(use:\u00a0official,\u00a0)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type 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/qicore/StructureDefinition/qicore-location"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Location_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Location </b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-location.html\">QICore Location</a></p></div><p><b>identifier</b>: <code>http://exampleoflocation.com</code>/NOBLE HOSPITAL\u00a0(use:\u00a0temp,\u00a0)</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 style=\"display: none\">-</td><td><b>Longitude</b></td><td><b>Latitude</b></td></tr><tr><td style=\"display: none\">*</td><td>-72.755911</td><td>42.138838</td></tr></table><p><b>managingOrganization</b>: <a href=\"Bundle-single-indv-mrp-obs-report.html#urn-uuid-ebc3f5c4-6700-34af-8323-85621c313726\">NOBLE HOSPITAL</a></p></div>"
      },
      "identifier" : [{
        "use" : "temp",
        "system" : "http://exampleoflocation.com",
        "value" : "NOBLE HOSPITAL"
      }],
      "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\"><a name=\"Observation_observation03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation03</b></p><a name=\"observation03\"> </a><a name=\"hcobservation03\"> </a><a name=\"hcobservation03-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-observation.html\">QICore Observation</a></p></div><p><b>status</b>: final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/observation-category exam}\">Exam</span></p><p><b>code</b>: <span title=\"Codes:{http://www.ama-assn.org/go/cpt 1111F}\">Discharge medications reconciled with the current medication list in outpatient medical record (COA) (GER)</span></p><p><b>subject</b>: <a href=\"Patient-patient03.html\">Virginia Hartman (official) female, DoB: 1983-09-12 ( Medical record number: 34567\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>encounter</b>: <a href=\"Encounter-encounter03.html\">Encounter: status = finished; class = inpatient encounter (ActCode#IMP); type = Respiratory therapy; period = 2018-05-29 11:00:00-0400 --&gt; 2018-05-29 11:00:00-0400</a></p><p><b>effective</b>: 2018-09-30 14:15:04+0000</p><p><b>issued</b>: 2018-09-30 14:15:04+0000</p><p><b>performer</b>: <a href=\"Practitioner-practitioner02.html\">Practitioner Emile Zieme(official)</a></p><p><b>value</b>: true</p></div>"
      },
      "status" : "final",
      "category" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
          "code" : "exam",
          "display" : "Exam"
        }]
      }],
      "code" : {
        "coding" : [{
          "system" : "http://www.ama-assn.org/go/cpt",
          "code" : "1111F",
          "display" : "Discharge medications reconciled with the current medication list in outpatient medical record (COA) (GER)"
        }]
      },
      "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\"><a name=\"Encounter_encounter02\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Encounter encounter02</b></p><a name=\"encounter02\"> </a><a name=\"hcencounter02\"> </a><a name=\"hcencounter02-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-encounter.html\">QICore Encounter</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-IMP\">ActCode</a> IMP: inpatient encounter</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.html\">Darien Bernard (official) male, DoB: 1967-06-13 ( Medical record number: 23456\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>period</b>: 2018-05-29 --&gt; 2018-05-29</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>DischargeDisposition</b></td></tr><tr><td style=\"display: none\">*</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" : "2018-05-29",
        "end" : "2018-05-29"
      },
      "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/qicore/StructureDefinition/qicore-organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_organization02\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization organization02</b></p><a name=\"organization02\"> </a><a name=\"hcorganization02\"> </a><a name=\"hcorganization02-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: versionId: id (PrimitiveType/Organization.meta.versionId): element = id -&gt; versionId=id[3]; Last updated: 2019-03-06 19:03:03+0000; </p><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Tax ID number/234567891\u00a0(use:\u00a0official,\u00a0)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type 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/qicore/StructureDefinition/qicore-practitioner"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_practitioner02\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner practitioner02</b></p><a name=\"practitioner02\"> </a><a name=\"hcpractitioner02\"> </a><a name=\"hcpractitioner02-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-practitioner.html\">QICore Practitioner</a></p></div><p><b>identifier</b>: Provider number/9998266512\u00a0(use:\u00a0official,\u00a0period:\u00a02005-07-16 09:00:00-0500 --&gt; (ongoing))</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></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"
    },
    "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/qicore/StructureDefinition/qicore-organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_organization03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization organization03</b></p><a name=\"organization03\"> </a><a name=\"hcorganization03\"> </a><a name=\"hcorganization03-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: versionId: id (PrimitiveType/Organization.meta.versionId): element = id -&gt; versionId=id[3]; Last updated: 2019-02-21 01:47:53+0000; </p><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Provider number/345678912\u00a0(use:\u00a0official,\u00a0), Provider number/082584\u00a0(use:\u00a0secondary,\u00a0)</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/qicore/StructureDefinition/qicore-practitioner"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_practitioner01\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner practitioner01</b></p><a name=\"practitioner01\"> </a><a name=\"hcpractitioner01\"> </a><a name=\"hcpractitioner01-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-practitioner.html\">QICore Practitioner</a></p></div><p><b>identifier</b>: Provider number/345678912\u00a0(use:\u00a0official,\u00a0), Provider number/082583\u00a0(use:\u00a0secondary,\u00a0)</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" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_patient03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient patient03</b></p><a name=\"patient03\"> </a><a name=\"hcpatient03\"> </a><a name=\"hcpatient03-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: versionId: id (PrimitiveType/Patient.meta.versionId): element = id -&gt; versionId=id[4]; Last updated: 2019-02-07 18:47:34+0000; </p><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-patient.html\">QICore Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Virginia Hartman (official) female, DoB: 1983-09-12 ( Medical record number: 34567\u00a0(use:\u00a0usual,\u00a0))</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td>true</td><td style=\"background-color: #f3f5da\" title=\"Known status of Patient\">Deceased:</td><td>false</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Known Marital status of Patient\">Marital Status:</td><td colspan=\"3\"><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-MaritalStatus U}\">unmarried</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\">213 Lilac Ave. Freehold MI 48099 USA (home)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Language spoken\">Language:</td><td colspan=\"3\"><span title=\"Codes:{urn:ietf:bcp:47 en-US}\">English (Region=United States)</span> (preferred)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Patient Links\">Links:</td><td colspan=\"3\"><ul><li>Managing Organization: <a href=\"Organization-organization03.html\">Organization DaVinciHospital03</a></li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.\">US Core Ethnicity Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CDCREC.html#CDCREC-2186-5\">CDC Race and Ethnicity</a> 2186-5: Not Hispanic or Latino</li><li>text: Not Hispanic or Latino</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc). This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9).\"><a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-birthsex.html\">US Core Birth Sex Extension</a></td><td colspan=\"3\">F</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\n\n - American Indian or Alaska Native\n - Asian\n - Black or African American\n - Native Hawaiian or Other Pacific Islander\n - White.\">US Core Race Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CDCREC.html#CDCREC-2054-5\">CDC Race and Ethnicity</a> 2054-5: Black or African American</li><li>text: Black or African American</li></ul></td></tr></table></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\"><a name=\"Encounter_encounter03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Encounter encounter03</b></p><a name=\"encounter03\"> </a><a name=\"hcencounter03\"> </a><a name=\"hcencounter03-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-encounter.html\">QICore Encounter</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-IMP\">ActCode</a> IMP: inpatient encounter</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.html\">Virginia Hartman (official) female, DoB: 1983-09-12 ( Medical record number: 34567\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>period</b>: 2018-05-29 11:00:00-0400 --&gt; 2018-05-29 11:00:00-0400</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>DischargeDisposition</b></td></tr><tr><td style=\"display: none\">*</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" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MeasureReport_indv-measurereport02a\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MeasureReport indv-measurereport02a</b></p><a name=\"indv-measurereport02a\"> </a><a name=\"hcindv-measurereport02a\"> </a><a name=\"hcindv-measurereport02a-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-indv-measurereport-deqm.html\">DEQM Individual MeasureReport Profile</a></p></div><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"Measure-measure-mrp-example.html\">MRP Measure</a></p><p><b>subject</b>: <a href=\"Patient-patient02.html\">Darien Bernard (official) male, DoB: 1967-06-13 ( Medical record number: 23456\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"Organization-organization01.html\">Organization DaVinciHospital01</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><blockquote><p><b>id</b></p>initial-population</blockquote><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><blockquote><p><b>id</b></p>numerator</blockquote><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><blockquote><p><b>id</b></p>denominator</blockquote><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.html\">Observation Discharge medications reconciled with the current medication list in outpatient medical record (COA) (GER)</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\"><a name=\"Observation_observation02\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation02</b></p><a name=\"observation02\"> </a><a name=\"hcobservation02\"> </a><a name=\"hcobservation02-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-observation.html\">QICore Observation</a></p></div><p><b>status</b>: final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/observation-category exam}\">Exam</span></p><p><b>code</b>: <span title=\"Codes:{http://www.ama-assn.org/go/cpt 1111F}\">Discharge medications reconciled with the current medication list in outpatient medical record (COA) (GER)</span></p><p><b>subject</b>: <a href=\"Patient-patient02.html\">Darien Bernard (official) male, DoB: 1967-06-13 ( Medical record number: 23456\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>encounter</b>: <a href=\"Encounter-encounter02.html\">Encounter: status = finished; class = inpatient encounter (ActCode#IMP); type = Fixation of fracture; period = 2018-05-29 11:00:00-0400 --&gt; 2018-05-29 11:00:00-0400</a></p><p><b>effective</b>: 2018-09-30 14:15:04+0000</p><p><b>issued</b>: 2018-09-30 14:15:04+0000</p><p><b>performer</b>: <a href=\"Practitioner-practitioner02.html\">Practitioner Emile Zieme(official)</a></p><p><b>value</b>: true</p></div>"
      },
      "status" : "final",
      "category" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
          "code" : "exam",
          "display" : "Exam"
        }]
      }],
      "code" : {
        "coding" : [{
          "system" : "http://www.ama-assn.org/go/cpt",
          "code" : "1111F",
          "display" : "Discharge medications reconciled with the current medication list in outpatient medical record (COA) (GER)"
        }]
      },
      "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" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MeasureReport_indv-measurereport02\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MeasureReport indv-measurereport02</b></p><a name=\"indv-measurereport02\"> </a><a name=\"hcindv-measurereport02\"> </a><a name=\"hcindv-measurereport02-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-indv-measurereport-deqm.html\">DEQM Individual MeasureReport Profile</a></p></div><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"Measure-measure-mrp-example.html\">MRP Measure</a></p><p><b>subject</b>: <a href=\"Patient-patient01.html\">Jairo Webster (official) male, DoB: 1946-12-16 ( Medical record number: 12345\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"Organization-organization01.html\">Organization DaVinciHospital01</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><blockquote><p><b>id</b></p>initial-population</blockquote><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><blockquote><p><b>id</b></p>numerator</blockquote><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><blockquote><p><b>id</b></p>denominator</blockquote><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.html\">Observation Discharge medications reconciled with the current medication list in outpatient medical record (COA) (GER)</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/qicore/StructureDefinition/qicore-organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_organization01\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization organization01</b></p><a name=\"organization01\"> </a><a name=\"hcorganization01\"> </a><a name=\"hcorganization01-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: versionId: id (PrimitiveType/Organization.meta.versionId): element = id -&gt; versionId=id[4]; Last updated: 2019-02-21 01:47:54+0000; </p><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Tax ID number/123456789\u00a0(use:\u00a0official,\u00a0)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type 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" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MeasureReport_indv-measurereport02b\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MeasureReport indv-measurereport02b</b></p><a name=\"indv-measurereport02b\"> </a><a name=\"hcindv-measurereport02b\"> </a><a name=\"hcindv-measurereport02b-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-indv-measurereport-deqm.html\">DEQM Individual MeasureReport Profile</a></p></div><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"Measure-measure-mrp-example.html\">MRP Measure</a></p><p><b>subject</b>: <a href=\"Patient-patient03.html\">Virginia Hartman (official) female, DoB: 1983-09-12 ( Medical record number: 34567\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"Organization-organization01.html\">Organization DaVinciHospital01</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><blockquote><p><b>id</b></p>initial-population</blockquote><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><blockquote><p><b>id</b></p>numerator</blockquote><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><blockquote><p><b>id</b></p>denominator</blockquote><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.html\">Observation Discharge medications reconciled with the current medication list in outpatient medical record (COA) (GER)</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\"><a name=\"Encounter_encounter01\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Encounter encounter01</b></p><a name=\"encounter01\"> </a><a name=\"hcencounter01\"> </a><a name=\"hcencounter01-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-encounter.html\">QICore Encounter</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-IMP\">ActCode</a> IMP: inpatient encounter</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.html\">Jairo Webster</a></p><p><b>period</b>: 2018-05-29 11:00:00-0400 --&gt; 2018-05-29 11:00:00-0400</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>DischargeDisposition</b></td></tr><tr><td style=\"display: none\">*</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\"><a name=\"Observation_observation01\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation01</b></p><a name=\"observation01\"> </a><a name=\"hcobservation01\"> </a><a name=\"hcobservation01-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-observation.html\">QICore Observation</a></p></div><p><b>status</b>: final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/observation-category exam}\">Exam</span></p><p><b>code</b>: <span title=\"Codes:{http://www.ama-assn.org/go/cpt 1111F}\">Discharge medications reconciled with the current medication list in outpatient medical record (COA) (GER)</span></p><p><b>subject</b>: <a href=\"Patient-patient01.html\">Jairo Webster (official) male, DoB: 1946-12-16 ( Medical record number: 12345\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>encounter</b>: <a href=\"Encounter-encounter01.html\">Encounter: status = finished; class = inpatient encounter (ActCode#IMP); type = Encounter for problem (procedure); period = 2018-05-29 11:00:00-0400 --&gt; 2018-05-29 11:00:00-0400</a></p><p><b>effective</b>: 2018-09-29 14:15:04+0000</p><p><b>issued</b>: 2018-09-29 14:15:04+0000</p><p><b>performer</b>: <a href=\"Practitioner-practitioner01.html\">Practitioner Ronald Bone </a></p><p><b>value</b>: true</p></div>"
      },
      "status" : "final",
      "category" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
          "code" : "exam",
          "display" : "Exam"
        }]
      }],
      "code" : {
        "coding" : [{
          "system" : "http://www.ama-assn.org/go/cpt",
          "code" : "1111F",
          "display" : "Discharge medications reconciled with the current medication list in outpatient medical record (COA) (GER)"
        }]
      },
      "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" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_patient01\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient patient01</b></p><a name=\"patient01\"> </a><a name=\"hcpatient01\"> </a><a name=\"hcpatient01-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: versionId: id (PrimitiveType/Patient.meta.versionId): element = id -&gt; versionId=id[5]; Last updated: 2019-02-11 14:19:25+0000; </p><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-patient.html\">QICore Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Jairo Webster (official) male, DoB: 1946-12-16 ( Medical record number: 12345\u00a0(use:\u00a0usual,\u00a0))</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td>true</td><td style=\"background-color: #f3f5da\" title=\"Known status of Patient\">Deceased:</td><td>false</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Known Marital status of Patient\">Marital Status:</td><td colspan=\"3\"><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}\">Married</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\">7496 Beaver Ridge Ave Thornton NJ 07003 USA (home)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Language spoken\">Language:</td><td colspan=\"3\"><span title=\"Codes:{urn:ietf:bcp:47 en-US}\">English (Region=United States)</span> (preferred)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Patient Links\">Links:</td><td colspan=\"3\"><ul><li>Managing Organization: <a href=\"Organization-organization01.html\">Organization DaVinciHospital01</a></li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.\">US Core Ethnicity Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CDCREC.html#CDCREC-2186-5\">CDC Race and Ethnicity</a> 2186-5: Not Hispanic or Latino</li><li>text: Not Hispanic or Latino</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc). This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9).\"><a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-birthsex.html\">US Core Birth Sex Extension</a></td><td colspan=\"3\">M</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\n\n - American Indian or Alaska Native\n - Asian\n - Black or African American\n - Native Hawaiian or Other Pacific Islander\n - White.\">US Core Race Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CDCREC.html#CDCREC-2106-3\">CDC Race and Ethnicity</a> 2106-3: White</li><li>text: White</li></ul></td></tr></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"
      }
    },
    "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" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_patient02\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient patient02</b></p><a name=\"patient02\"> </a><a name=\"hcpatient02\"> </a><a name=\"hcpatient02-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: versionId: id (PrimitiveType/Patient.meta.versionId): element = id -&gt; versionId=id[4]; Last updated: 2019-03-06 19:03:03+0000; </p><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-patient.html\">QICore Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Darien Bernard (official) male, DoB: 1967-06-13 ( Medical record number: 23456\u00a0(use:\u00a0usual,\u00a0))</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td>true</td><td style=\"background-color: #f3f5da\" title=\"Known status of Patient\">Deceased:</td><td>false</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Known Marital status of Patient\">Marital Status:</td><td colspan=\"3\"><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}\">Married</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\">6 Rockwell Street Lynnwood NJ 07420 USA (home)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Language spoken\">Language:</td><td colspan=\"3\"><span title=\"Codes:{urn:ietf:bcp:47 en-US}\">English (Region=United States)</span> (preferred)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Patient Links\">Links:</td><td colspan=\"3\"><ul><li>Managing Organization: <a href=\"Organization-organization02.html\">Organization DaVinciHospital02</a></li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.\">US Core Ethnicity Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CDCREC.html#CDCREC-2186-5\">CDC Race and Ethnicity</a> 2186-5: Not Hispanic or Latino</li><li>text: Not Hispanic or Latino</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc). This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9).\"><a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-birthsex.html\">US Core Birth Sex Extension</a></td><td colspan=\"3\">M</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\n\n - American Indian or Alaska Native\n - Asian\n - Black or African American\n - Native Hawaiian or Other Pacific Islander\n - White.\">US Core Race Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CDCREC.html#CDCREC-2028-9\">CDC Race and Ethnicity</a> 2028-9: Asian</li><li>text: Asian</li></ul></td></tr></table></div>"
      },
      "extension" : [{
        "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" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: MeasureReport summ-measurereport01</b></p><a name=\"summ-measurereport01\"> </a><a name=\"hcsumm-measurereport01\"> </a><a name=\"hcsumm-measurereport01-en\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-summary-measurereport-deqm.html\">DEQM Summary MeasureReport Profile</a></p></div><p><b>status</b>: complete</p><p><b>type</b>: summary</p><p><b>measure</b>: <a href=\"Measure-measure-mrp-example.html\">MRP Measure</a></p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"Organization-organization01.html\">Organization DaVinciHospital01</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><blockquote><p><b>id</b></p>initial-population</blockquote><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><blockquote><p><b>id</b></p>numerator</blockquote><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><blockquote><p><b>id</b></p>denominator</blockquote><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]