QI-Core Implementation Guide
5.0.0 - STU5 United States of America flag

QI-Core Implementation Guide, published by http://www.hl7.org/Special/committees/cqi/index.cfm. This is not an authorized publication; it is the continuous build for version 5.0.0). This version is based on the current content of https://github.com/HL7/fhir-qi-core/ and changes regularly. See the Directory of published versions


This page lists the change history for each version of QI Core.

STU5 Release (5.0.0)

  1. Add ODH - 2016-09 qicore #21 (FHIR-12091)
  2. Add ODH - 2018-Jan QI-Core #33 (FHIR-14998)
  3. Update QI-Core to incorporate changes from US Core 3.2.0 ballot (FHIR-30116)
  4. qicore-encounter-diagnosisPresentOnAdmission not applicable for outpatient encounters but always required when sending a diagnosis (FHIR-31764)
  5. Update Cumulative Medication Duration examples in upcoming update (FHIR-32007)
  6. Add extension for MedicationDispense.statusChange (FHIR-32805)
  7. Add pattern for blood pressure (FHIR-32945)
  8. QI Core Specimen Profile not used in QI Core ImagingStudy or QI Core ServiceRequest (FHIR-32967)
  9. QI Core ImagingStudy needs more Resource types for Referrer and Interpreter (FHIR-32968)
  10. Mark timing.bounds as mustSupport (FHIR-33017)
  11. Mark mandatory top level elements MUST SUPPORT (FHIR-33029)
  12. QI Core Immunization Profile should only allow Completed status and statusReason should not be allowed (FHIR-33087)
  13. Remove duplicate profile statements (FHIR-33199)
  14. FamilyMemberHistory profile needs to have a more constrained binding on Relationship code set (FHIR-33230)
  15. Need ClaimResponse Resource added to QI Core Profiles (FHIR-33373)
  16. Should Encounter.diagnosis.condition be restricted to reference (condition) and NOT (procedure) and specify the change in QDM mapping - September Update (FHIR-33491)
  17. Medication.code Preferred binding is less than US Core extensible binding (FHIR-34071)
  18. Medication.form appears on the Differential View but no apparent change from US Core (FHIR-34072)
  19. Aligning with US Core - New conformance expectations page (FHIR-34154)
  20. Align with US CORE on VSAC terminology references (FHIR-34167)
  21. Change $docref start and end input parameter types from date to dateTime (FHIR-34169)
  22. Align with US Core 4.0 - must support complex elements (FHIR-34176)
  23. Align with US Core 4.0 - include VSAC instructions in terminology section (FHIR-34177)
  24. Align with US Core 4.0 - must support choice of profile elements (FHIR-34178)
  25. Align with US Core 4.0 - align invariants and binding change in PractitionerRole (FHIR-34179)
  26. CommunicationNotDone profile does not have Subject as Must Support (FHIR-34313)
  27. AdverseEvent. referenceDocument does not reference US Core Document Reference (FHIR-34367)
  28. AdverseEvent.contributor does not reference QI Core profiles for Contributor or suspectEntity.causality.author (FHIR-34368)
  29. Organization profile should mirror US Core telecom must support elements of system and value (FHIR-34482)
  30. Add due duration to QI Core Goal.target (FHIR-34484)
  31. Consider updating StructureDefinition-qicore-diagnosticreport-lab to mirror US Core for performer element (FHIR-34531)
  32. Consider updating choice type for Encounter.referenceReason to mirror US Core (FHIR-34534)
  33. Careplan.text.div should be MS to mirror US Core (FHIR-34535)
  34. Consider adding MS datatypes on observation.value[x] (FHIR-34536)
  35. Consider adding MS datatypes on observation.effective[x] (FHIR-34537)
  36. Update definition of diagnosticreport.effective[x] (FHIR-34557)
  37. Consider adding MS on medicationrequest.requester choice type of Practitioner (FHIR-34559)
  38. ServiceRequest.statusReason is not bound to a value set yet it is an extension added for use by QI Core (FHIR-35100)
  39. Change example value sets for MS items to Preferred - Immunization-related (FHIR-35813)
  40. Change example value sets for MS items to Preferred - Medication-related (FHIR-35814)
  41. Change QI Core Communication Resource MS items to Preferred Value Set bindings (FHIR-35815)
  42. QI Core Care Plan and Goal Profiles have MS items with example bindings to value sets - change to Preferred (FHIR-35816)
  43. Change value set bindings for QI-Core AllergyIntolerance, AdverseEvent, Condition, Procedure elements with MS (FHIR-35817)
  44. QICore Flag profile elements with MS example bindings should change to preferred bindings (FHIR-35818)
  45. QICore ServiceRequest, ServiceNotRequested MS item should have preferred value set bindings (FHIR-35819)
  46. Change QICore Specimen value set bindings where items are Must Support (FHIR-35820)
  47. Device-related QI-Core profile elements that are Must Support should have preferred bindings, not example bindings (FHIR-35821)
  48. QI-Core observation-related profile Must Support elements should all have Preferred bindings, not example bindings (FHIR-35822)
  49. QI-Core Task profile elements that are Must Support should use preferred bindings to value sets, not examples (FHIR-35823)
  50. QI-Core Encounter and Organization Profile MS elements should have preferred value set bindings, not examples (FHIR-35824)
  51. QI Core Profile on FamilyMemberHistory has Relationship as a Must Support field but code set is Must Support (FHIR-35903)
  52. Nutrition Order is not consistent with out Request pattern resources (FHIR-35944)
  53. QI Core Substance has code as Must Support but bound to example code set (FHIR-35946)
  54. Goal.target.measure and goal.target.date are both required so should be Must Support (FHIR-35947)
  55. Don’t assign system values for tax id or other identifiers (FHIR-35971)
  56. Need practitionerRole in Encounter.participant.individual as it supports specialty taxonomy which is needed in some quality scenarios (FHIR-36745)
  57. Update PractionerRole.specialty value set binding to match US Core 5.0.0 (FHIR-37365)
  58. Update ServiceRequest to match US Core 5.0.0 (FHIR-37447)
  59. Update QI-Core to reference new US Core 5.0 Observation profiles (FHIR-37457)
  60. Create new QI-Core QuestionnaireResponse Profile consistent with US Core 5.0.0 (FHIR-37458)
  61. Create new Observation Clinical Test Result profile consistent with US Core 5.0.0 (FHIR-37459)
  62. Create new Observation Imaging Result Profile consistent with US Core 5.0.0 (FHIR-37460)
  63. Create Observation Sexual Orientation Profile consistent with US Core 5.0.0 (FHIR-37461)
  64. Create new Observation Social History Profile consistent with US Core 5.0.0 (FHIR-37462)
  65. Create new Observation Survey Profile Consistent with US Core 5.0.0 (FHIR-37463)
  66. Add new Conditions Problems and Health Concerns Profile and Encounter Diagnosis Profile consistent with US Core 5.0.0 (FHIR-37464)
  67. Update ObservationNotDone profile to indicate use for all observation profiles (FHIR-37489)
  68. Update QICore Observation Profile to indicate restricted use (FHIR-37490)
  69. Add full QI-Core Laboratory Result Observation Profile (FHIR-37505)
  70. Add Must Support for Procedure.usedReference (FHIR-37532)
  71. Add note to balloters for feedback in next ballot version (FHIR-37535)
  72. Update QDM to QI-Core Mapping section (FHIR-37536)
  73. Modify text on introduction page for QI-Core (FHIR-37539)
  74. Update Model Info (FHIR-37579)
  75. Encounter.hospitalization.dischargeDisposition binding - for QI-Core R5 is incorrect (FHIR-37627)
  76. TaskNotDone Task.code binding to task-code value set should be preferred, not example (FHIR-37656)
  77. Changes to Coverage profile (FHIR-37669)
  78. Remove CCN Number Identifier Slice from QI Core Practitioner as this only applies to an Organization (FHIR-37751)
  79. Adding ODH capability to QICore (FHIR-37755)
  80. Remove references for .subject in ObservationLab and ObservationClinicalTest (FHIR-37782)
  81. Small typo (FHIR-37788)
  82. Modify language in section 1.8 - Relationship to Other Initiatives (FHIR-37806)
  83. CCN system should use URL not OID (FHIR-37900)
  84. Put all Updates in Change tab (FHIR-38077)
  85. Blood Pressure Pattern Example (FHIR-38112)
  86. Inconsistency In Naming Profiles (FHIR-38119)
  87. Provide links to Example Source (FHIR-38135)
  88. POA value set codes (FHIR-38181)
  89. 2 Resource Profile name for Medication Not Requested / Service Not Requested are not align with other negation profiles (FHIR-38182)
  90. Suggest that examples that are CQL based be added to the QICore manual in addition to the FHIR based examples that already exist (FHIR-38185)
  91. QICoreProcedureType Value Set missing CLD (FHIR-38204)
  92. Consistency of multi-word element names (FHIR-38213)
  93. Allergy Example (FHIR-38217)
  94. Typo correction to Section 1.4 (FHIR-38315)
  95. Encounter.diagnosis reference (FHIR-38316)
  96. Typo correction to Section 2.2 (FHIR-38360)
  97. Typo correction to Section 9.1 (FHIR-38363)
  98. Defining URL should be anchored in THO. 1. (FHIR-38548)
  99. Defining URL should be anchored in THO. 2. (FHIR-38549)
  100. Defining URL should be anchored in THO. 3. (FHIR-38550)
  101. Defining URL should be anchored in THO. 4. (FHIR-38551)
  102. Defining URL should be anchored in THO. 5. (FHIR-38552)
  103. Defining URL should be anchored in THO. 6. (FHIR-38553)
  104. Defining URL should be anchored in THO. 7. (FHIR-38554)
  105. Defining URL should be anchored in THO. 8. (FHIR-38555)
  106. Defining URL should be anchored in THO. 9. (FHIR-38556)
  107. Defining URL should be anchored in THO. 10. (FHIR-38557)
  108. Defining URL should be anchored in THO. 11. (FHIR-38558)
  109. Defining URL should be anchored in THO. 12. (FHIR-38559)
  110. Defining URL should be anchored in THO. 13. (FHIR-38560)
  111. Defining URL should be anchored in THO. 14. (FHIR-38561)
  112. Defining URL should be anchored in THO. 15. (FHIR-38562)
  113. Defining URL should be anchored in THO. 16. (FHIR-38563)
  114. Defining URL should be anchored in THO. 20. (FHIR-38567)
  115. Defining URL should be anchored in THO. 21. (FHIR-38568)
  116. Defining URL should be anchored in THO. 22. (FHIR-38569)
  117. Defining URL should be anchored in THO. 23. (FHIR-38570)
  118. Defining URL should be anchored in THO. 25. (FHIR-38572)
  119. Defining URL should be anchored in THO. 27. (FHIR-38574)
  120. Consider topic, rather than reasonCode as the primary code path for Communication and CommunicationNotDone (FHIR-38591)
  121. Ensure negation profiles are disjoint (FHIR-38788)
  122. Provide consistent naming for QI-Core negation profiles (FHIR-38850)
  123. Update QICoreCommon Library (FHIR-39164)
  124. Update QDM to QI-Core Mappings for new terms for negation profiles (FHIR-39307)
  125. statusReason extension is unbounded (FHIR-39361)

STU4.1 Release with 1 Technical Errata for FHIR R4 (v4.1.1)

STU4 v4.1.1

  • FHIR-35873: Corrected version-independent links to USCore throughout
  • FHIR-35802: Corrected negation examples and added guidance for usage of valueset-based negation

STU4.1 Release for FHIR R4 (v4.1.0)

STU4 v4.1.0

  1. Broken Link for QUICK AdverseEvent actuality value set binding (FHIR-23934)
  2. Immunization.occurrence should remove the String choice (FHIR-26407)
  3. MedicationNotDispensed (FHIR-26409)
  4. Naming of QUICK vs QI-Core Logical View (FHIR-26592)
  5. Medication list patient reported medications use Intent = Plan (not order) (FHIR-26829)
  6. wrong link in QDM to QICore mapping (FHIR-27031)
  7. Remove imagingStudy must support from the QICoreDiagnosticReportLab profile (FHIR-27163)
  8. Add TIN to QICore Organization Profile (FHIR-27804)
  9. DEQM Practitioner and DEQM Organization Profile should be added to QI Core (FHIR-28157)
  10. Patient resource generalpractitioner needs to consider PractitionerRole (https://jira.hl7.org/browse/FHIR-28220))
  11. Can you add my affiliation? (FHIR-28231)
  12. change D.role to D.use in example with Encounter.diagnosis (FHIR-28241)
  13. Add MUST HAVE for MedicationRequest timing elements (FHIR-28286)
  14. Update Present On Admission in QDM to QI Core Mapping (FHIR-29703)
  15. Change mapping of "Encounter, Performed" code from Encounter.class to Encounter.type (FHIR-29819)
  16. QDM to QI-Core mapping for AdverseEvent error (FHIR-30098)
  17. Add QICoreModelInfo (FHIR-30771)
  18. Include US Core errata (3.1.1) to QI-Core Update process (FHIR-31350)
  19. Add MedicationDispense.whenPrepared MUST SUPPORT (FHIR-31609)
  20. Update QDM to QI-Core Mapping to address QDM 5.6 (FHIR-31629)
  21. Add guidance about use of references in profiles QI-Core inherits from US Core and FHIR (FHIR-31738)
  22. Update QDM to QI-Core mapping for (FHIR-31740)
  23. Profile Procedure NOT Done - why is element code not required (FHIR-31929)
  24. Procedure NOT Done - what is the intent of the valueset-reference in Code element (FHIR-31930)
  25. Procedure NOT Done - recorded does not have a clear description (FHIR-31931)
  26. Coverage.period shows in Differential but we cannot identify the change from FHIR Core (FHIR-31932)
  27. QI Core Observation.code binding is just example to LOINC (FHIR-31933)
  28. QI Core IG does not have a Table of Contents page (FHIR-31935)
  29. QDM to QI-Core mapping Section 8.1 correct text to QDM 5.6 (FHIR-31974)
  30. Adverse Event QDM-to-QI-Core mapping errata (FHIR-31975)
  31. QDM to Qi-Core mapping AllergyIntolerance (FHIR-31976)
  32. QDM to Qi-Core sections 8.4.1, 8.4.3 Assessment Order/Recommended (FHIR-31977)
  33. QDM to QI-Core mapping Communication, Performed (FHIR-31978)
  34. QDM to Qi-Core mapping for Device Order, Device Recommended (FHIR-31979)
  35. QDM to QI-Core mapping Diagnostic Study corrections (FHIR-31980)
  36. QDM to QI-Core mapping - Encounter (FHIR-31981)
  37. QDM to QI-Core mapping Immunization Administered status error (FHIR-31982)
  38. QDM to QI-Core mapping Intervention performed errors (FHIR-31983)
  39. QDM to QI-Core mapping Laboratory order and recommended error (FHIR-31984)
  40. QDM to QI-Core mapping Medication Administered error (FHIR-31985)
  41. QDM to QI-Core mapping Medication, Discharge error (FHIR-31987)
  42. QDM to QI-Core mapping update for Medication, Dispensed (FHIR-31988)
  43. QDM to QI-Core mapping Physical Exam Order and Recommended error (FHIR-31989)
  44. QDM to QI Core mapping changes for Procedure, Order, Procedure, Recommended and Procedure, Performed (FHIR-31990)
  45. QDM to QI-Core mapping - error in Immunization, Administered not done mapping ([FHIR-32005](https://jira.hl7.org/browse/FHIR-32005
  46. QDM to QI-Core mapping for "Medication, Order" status constraints ([FHIR-32037](https://jira.hl7.org/browse/FHIR-32037
  47. CommunicationNotDone code requires change in cardinality and modeling (FHIR-32052)
  48. DeviceRequestNotDone code binding and cardinality may require a specific slice for the eCQM use case (FHIR-32053)
  49. ImmunizationNotDone should allow indication an individual immunization was not performed and a slice to indicate none of the members of a value set was performed (FHIR-32054)
  50. MedicationNotAdministered requires ability to specify a single medication or an entire value set slice (FHIR-32055)
  51. MedicationNotDispensed should allow indication of a single medication not dispensed or a slice to indicate an entire value set was not dispensed (FHIR-32056)
  52. MedicationNotRequested should allow reference to a single medication not requested or a slice for a value set of all medications not requested (FHIR-32057)
  53. ObservationCancelled should allow reference to a single observation not performed or a slice for a value set for which none of the items were performed (FHIR-32058)
  54. ServiceNotRequested requires ability to specify a single service not requested or a slice for any one of a value set of services not requested (FHIR-32059)
  55. DiagnosticReportLab does not have Performer or Issued as Must Support even though the US Core Specification Does (FHIR-32235)
  56. How to reference TaskNotDone (FHIR-32273)
  57. Create QICorePresentOnAdmission value set (FHIR-32378)
  58. Add Must Support to Procedure.usedCode (FHIR-32991)
  59. Add Must Support for ServiceRequest.intent, MedicationRequest.intent, NutritionOrder.intent, NutritionOrder.status (FHIR-33027)
  60. Update identifiers throughout (FHIR-33085)
  61. Remove Authoring section (FHIR-33260)

The following tickets listed below were incorporated from the US Core errata (3.1.1):

  • Add guidance for representing patient name suffix and previous patient name to the US Core Patient Profile (FHIR-28129)
  • Correct copy/paste error in Goal Profile (FHIR-28109)
  • Correct US Core Provider Speciality (NUCC) ValueSet to hide abstract grouping codes (FHIR-27975)
  • Added example of US Core Direct Extension to Practitioner-2 Example (FHIR-27947)
  • Corrected technical errors in pediatric profiles StructureDefinitions (FHIR-27946)
  • Corrected errors in DiagnosticReport Cardiology Example (FHIR-27913)
  • Update Federal Register link for OMB race and ethnicity category classifications. (FHIR-27907)
  • Clarified token search syntax (FHIR-27897)
  • Corrected US Core DocumentReference Profile to support multiple attachments (FHIR-25778)
  • Fix FHIRPath Expression in USCoreGoalTargetDate (FHIR-27892)
  • Fix FHIRPath Expression in USCoreProcedureDate (FHIR-27887)
  • Add omitted ge comparators to SearchParameters (FHIR-27893)
  • Remove Must Support References to non US Core Profiles (FHIR-27876)
  • Add missing reaction to the US Core AllergyIntolerance Profile (FHIR-27867)
  • Clarify reference to US Core Patient in Vitals Signs Profiles (FHIR-27857)
  • Corrected US Core Pulse Oximetry Profile component.valueQuantity.code and component.valueQuantity.unit min from 0 to 1 to be consistent with the valueQuantity constraints within US Core (FHIR-27846)
  • Correct UCUM Unit in US Core Pulse Oximetry Profile Text Summary (FHIR-27845)
  • Update Procedure Codes Value Set to include ICD-10 PCS codes (FHIR-27836)
  • Update Procedure Codes Value Set to include CDT codes (FHIR-27737)
  • Clarify that pediatric vital sign percentile Observations should reference growth chart (FHIR-27549)
  • Added Missing US core Head Occipital-frontal Circumference Percentile Profile (FHIR-27542)
  • Correct requirements for supporting CLIA identifiers (FHIR-27158)
  • Change Description of ICD-10-PCS Value Set (FHIR-27116)
  • Correct AllergyIntolerance guidance for verificationStatus (FHIR-27096)
  • Fix example US Core heart-rate example (FHIR-27086)
  • Review period comments Update smoking status codes to align with USCDI (FHIR-27082)
  • Fix invariant provenance-1 (FHIR-27065)
  • Fix invalid json snippet (FHIR-27001)
  • Review period comments Remove Provenance requirement from Medication, Location, Practitioner, PractitionerRole, and Organization and correct copy and paste error to Medication and Provenance searchType support in CapabilityStatement (FHIR-26840),(FHIR-28161)
  • Correction on USCDI Table change MedicationStatement to MedicationRequest and remove references to MedicationStatement in the Medication Profile and CapabilityStatements (FHIR-26840)
  • Clarify that US Core Location/PractitionerRole are not being referenced by other resources (FHIR-26840)
  • Correct editing error restoring Write and Operation capability guidance into DocumentReference QuickStart (FHIR-26840)
  • Clarify guidance that servers SHALL support search with status if status required (FHIR-26840)
  • Correct canonical url for ImplementationGuide (FHIR-26686)
  • Correct system URI for ICD-10 procedure codes (FHIR-26679)
  • Fix invariant us-core-1 (FHIR-26605)
  • Change valueCode min from 0 to 1 for US Core Birth Sex Extension and valueBoolean min from 0 to 1 forUS Core Direct email Extension (FHIR-26459)
  • Change valueQuantity min from 1 to 0 for US Core Pediatric BMI for Age Observation Profile and US Core Pediatric Weight for Height Observation Profile (FHIR-26363)
  • Add page contents to Clinical Notes and Basic Provenance pages (FHIR-25785)
  • Fix duplicate URL causing validation failure. (FHIR-25536)
  • Fix Invariant us-core-8 (FHIR-25459)
  • Corrected the wording should support to shall support in Clinical Notes Guidance (FHIR-25455)
  • Fix Invariant us-core-8 to allow for Data Absent Reason Extension on Patient name.(FHIR-25249)
  • Fix Link to LOINC LP29708-2 (FHIR-25213)
  • Corrected guidance for conveying Patient-Reported medications (FHIR-25035)

STU4 Release for FHIR R4 (v4.0.0)

STU4 v4.0.0

  • Created negation profiles
  • Added patterns pages and CQL examples
  • Corrections throughout
  • Updated QDM-to-QI-Core mapping
  • Added negation reason value set and bindings

STU4 Ballot for FHIR R4 (v3.3.0)

STU 4 Ballot (v3.3.0)

  • Updated profiles to be based on FHIR R4 and US Core STU 3
  • #22645 Added profiles on Immunization and Evaluation
  • #15012 Added a profile on NutritionOrder
  • #20727 Updated Observation documentation to provide clarity on use of FHIR and US Core profiles
  • #20610 Created the notDone extension and modified the DeviceUseStatement profile to use it; added the DeviceRequest profile, use the doNotPerform extension
  • #22646 Relaxed Must Support requirement on some fields of Immunization and ImmunizationRecommendation profiles
  • #14991 Added an example of using body position with an Observation

STU3.2 Release for FHIR STU3 (v3.2.0)

STU3 v3.2.0

  • Updated profiles to be based on US Core 2.0.0
  • Derived Encounter and PractitionerRole profiles from US Core profiles

STU3 Release for FHIR STU3 (v3.1.0)

STU3 v3.1.0

  • Added profile for PractitionerRole and removed Practitioner.role extension
  • Added profile for Task
  • Established pattern for representing QDM Principal Diagnosis in Encounters
  • Relaxed conformance requirements from all profiles to profiles that are relevant to a particular use case

STU3 Ballot for FHIR STU3 (v2.1.0)

STU3 v2.1.0

  • Incorporates ballot reconciliation from all comments from the September 2016 ballot which have been applied to FHIR 3.0 and US Core Release 1.0.1
  • Includes mapping to QDM Version 5.3 Annotated available at: https://ecqi.healthit.gov/qdm
  • Includes an updated Mapping table from the QI-Core metadata to QDM 5.3
  • Includes a direct mapping from QDM version 5.3 to QI Core

STU2 Release for FHIR STU3 (v2.0.0)

STU2 v2.0.0

  • Updated to FHIR STU3 (3.0.1)
  • Changed from Universal Realm to US Realm
  • Derived from US Core profiles where possible
  • Added support for Claim and Coverage resources
  • Changed AdverseEvent profile to use the base resource
  • Numerous typographical and technical errors corrected

STU2 Ballot for FHIR STU3 Ballot (v1.6.0)

STU2 v1.6.0

  • Moved out of main FHIR publication package to its own home
  • Updated QI-Core profiles for changes to underlying specification
  • Added an additional profile on Condition
  • The QUICK logical model is included

STU1 Release for FHIR DSTU2 (v1.0.2)

STU1 v1.0.2

DSTU 1 (Permanent home)

DSTU1 Preview for FHIR STU1 (v1.0.0)

STU1 v1.0.0

DSTU1 Preview

DSTU1 Ballot for FHIR STU1 (v0.5.0)

STU1 v0.5.0

DSTU1 Ballot