Situational Awareness for Novel Epidemic Response
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Situational Awareness for Novel Epidemic Response, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 1.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-saner/ and changes regularly. See the Directory of published versions

: Patients By Risk Factor - JSON Representation

Draft as of 2024-05-18

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{
  "resourceType" : "Measure",
  "id" : "PatientsByRiskFactorWithSupplementalData",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/uv/saner/StructureDefinition/PublicHealthMeasure"
    ]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Measure</b><a name=\"PatientsByRiskFactorWithSupplementalData\"> </a><a name=\"hcPatientsByRiskFactorWithSupplementalData\"> </a></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\">ResourceMeasure &quot;PatientsByRiskFactorWithSupplementalData&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-PublicHealthMeasure.html\">Public Health Measure</a></p></div><p><b>Enables specification of proposed measure reporting</b>: Once per 1 days</p><p><b>url</b>: <code>http://hl7.org/fhir/uv/saner/Measure/PatientsByRiskFactorWithSupplementalData</code></p><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.5.0/NamingSystem-uri.html\" title=\"As defined by RFC 3986 (http://www.ietf.org/rfc/rfc3986.txt)(with many schemes defined in many RFCs). For OIDs and UUIDs, use the URN form (urn:oid:(note: lowercase) and urn:uuid:). See http://www.ietf.org/rfc/rfc3001.txt and http://www.ietf.org/rfc/rfc4122.txt \r\n\r\nThis oid is used as an identifier II.root to indicate the the extension is an absolute URI (technically, an IRI). Typically, this is used for OIDs and GUIDs. Note that when this OID is used with OIDs and GUIDs, the II.extension should start with urn:oid or urn:uuid: \r\n\r\nNote that this OID is created to aid with interconversion between CDA and FHIR - FHIR uses urn:ietf:rfc:3986 as equivalent to this OID. URIs as identifiers appear more commonly in FHIR.\r\n\r\nThis OID may also be used in CD.codeSystem.\">Uniform Resource Identifier (URI)</a>/urn:oid:2.16.840.1.113883.4.642.40.42.29.6</p><p><b>version</b>: 1.0.1</p><p><b>name</b>: PatientsByRiskFactor</p><p><b>title</b>: COVID-19 Patients By Risk Factor</p><p><b>status</b>: draft</p><p><b>experimental</b>: true</p><p><b>date</b>: 2024-05-18 21:25:01+0000</p><p><b>publisher</b>: HL7 International / Public Health</p><p><b>contact</b>: <a href=\"http://www.hl7.org/Special/committees/pher\">http://www.hl7.org/Special/committees/pher</a>, <a href=\"mailto:pher@lists.hl7.org\">pher@lists.hl7.org</a>, Keith W. Boone: <a href=\"mailto:mailto:kboone@ainq.com\">mailto:kboone@ainq.com</a></p><p><b>description</b>: This measure demonstrates automated reporting of patients with COVID-19 stratified by condition, and reporting supplemental data</p><h3>UseContexts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>Clinical Focus (Details: UsageContextType code focus = 'Clinical Focus', stated as 'null')</td><td>COVID-19 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOWMED CT</a>#840539006)</span></td></tr></table><p><b>jurisdiction</b>: World <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (m49.htm#001)</span></p><p><b>author</b>: Centers for Disease Control/National Healthcare Safety Network (CDC/NHSN): <a href=\"mailto:mailto:nhsn@cdc.gov\">mailto:nhsn@cdc.gov</a></p><blockquote><p><b>relatedArtifact</b></p><p><b>type</b>: documentation</p><p><b>label</b>: NHSN COVID-19 Reporting</p><p><b>display</b>: CDC/NHSN COVID-19 Patient Impact &amp; Hospital Capacity Module Home Page</p><p><b>url</b>: <a href=\"https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/acute-care-hospital/covid19/\">https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/acute-care-hospital/covid19/</a></p><blockquote><p><b>document</b></p></blockquote></blockquote><blockquote><p><b>relatedArtifact</b></p><p><b>type</b>: documentation</p><p><b>label</b>: How to import COVID-19 Summary Data</p><p><b>display</b>: Importing COVID-19 Patient Module Denominator data for Patient Safety Component</p><p><b>url</b>: <a href=\"https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/import-covid19-data-508.pdf\">https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/import-covid19-data-508.pdf</a></p><blockquote><p><b>document</b></p></blockquote></blockquote><blockquote><p><b>relatedArtifact</b></p><p><b>type</b>: documentation</p><p><b>label</b>: Table of Instructions</p><p><b>display</b>: Instructions for Completion of the COVID-19 Patient Impact and Hospital Capacity Module Form (CDC 57.130)</p><p><b>url</b>: <a href=\"https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/57.130-toi-508.pdf\">https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/57.130-toi-508.pdf</a></p><blockquote><p><b>document</b></p></blockquote></blockquote><blockquote><p><b>relatedArtifact</b></p><p><b>type</b>: documentation</p><p><b>label</b>: CSV File Template</p><p><b>display</b>: CDC/NHSN COVID-19 Reporting CSV File Template</p><p><b>url</b>: <a href=\"https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/covid19-test-csv-import.csv\">https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/covid19-test-csv-import.csv</a></p><blockquote><p><b>document</b></p></blockquote></blockquote><p><b>library</b>: <a href=\"Library-ComputableNHSNMeasureLibrary.html\">Computable NHSN Patient Impact and Hospital Capacity Measure Library</a></p><blockquote><p><b>group</b></p><blockquote><p><b>Attributes describing a group of measures</b></p><blockquote><p><b>url</b></p><code>subject</code></blockquote><p><b>value</b>: Patient in room <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#Encounter; <a href=\"https://browser.ihtsdotools.org/\">SNOWMED CT</a>#398284004)</span></p><blockquote><p><b>url</b></p><code>scoring</code></blockquote><p><b>value</b>: Queue Length <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-PublicHealthMeasureScoring.html\">Public Health Measure Scoring</a>#queue-length)</span></p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Structure <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-measure-type.html\">MeasureType</a>#structure)</span></p><blockquote><p><b>url</b></p><code>improvementNotation</code></blockquote><p><b>value</b>: Decreased score indicates improvement <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-measure-improvement-notation.html\">MeasureImprovementNotation</a>#decrease)</span></p><blockquote><p><b>url</b></p><code>rateAggregation</code></blockquote><p><b>value</b>: point-in-time</p></blockquote><p><b>code</b>: Hospital COVID-19 Patient Encounters Reporting <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-MeasureGroupSystem.html\">Measure Group System</a>#Encounters &quot;Encounters&quot;)</span></p><blockquote><p><b>population</b></p><p><b>code</b>: Patients with confirmed COVID-19 in any location. <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-MeasuredValues.html\">Measured Values in Sample Measures</a>#confirmedC19Pats &quot;All Confirmed COVID-19 Patients&quot;; <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#initial-population)</span></p><p><b>description</b>: Active encounters where the encounter diagnosis is suspected or confirmed COVID-19,\nor a Condition of confirmed COVID-19 was created during that encounter.  This includes the patients with laboratory-confirmed\nor clinically diagnosed COVID-19.</p><h3>Criteria</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Description</b></td><td><b>Name</b></td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td style=\"display: none\">*</td><td>This expression finds encounters that were active or finished in the reporting period, and their referenced Patient, Condition\nand Observation resources. It filters these based on cases where Encounter reports a reason or condition in the\nConfirmedCOVID19Diagnoses value set, or where a positive lab test from the Covid19Labs valueset, or where the patient\nhas any such associated Condition or Observation resources in the prior two weeks.</td><td>ConfirmedC19Pats</td><td>text/fhirpath</td><td>findAll('Encounter',\n    including('subject','condition','reasonReference'),\n    with('status').equalTo('in-progress,finished'),\n    with('date').within(%ReportingPeriod)\n ).onServers(%Base).\n where(\n   iif(\n     (Encounter.reasonCode | Condition.code).member0f(%ConfirmedCOVID19Diagnoses.url) |\n     Observation.where(code.member0f(%Covid19Labs.url) and value.member0f(%PositiveResults.url)),\n     true,\n     iif(\n       Patient.distinct()\n          .whereExists('Observation',\n            for('patient', $this.id),\n            with('status').equalTo(\n                'registered,preliminary,final,amended,corrected'),\n            with('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n            with('code').in(%Covid19Labs),\n            with('value-concept').in(%PositiveResults)\n       ).onServers(%Base),\n       true,\n       Patient.distinct()\n          .whereExists('Condition',\n            for('patient', $this.id),\n            with('verification-status').notEqualTo('refuted,entered-in-error').\n            with('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n            with('code').in(%ConfirmedCOVID19Diagnoses.url)\n       ).onServers(%Base)\n     )\n  )\n)\n.ofType(Encounter)\n.distinct()\n.aggregate(\n  iif($total.subject contains $this.subject, $total, $total | $this )\n)</td></tr></table></blockquote><blockquote><p><b>stratifier</b></p><p><b>code</b>: By Risk Factor <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>description</b>: Stratifies the population by Condition/RiskFactor</p><h3>Criteria</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Description</b></td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td style=\"display: none\">*</td><td>Final all conditions for each patient in the AllCOVID19RiskFactors ValueSet\nand stratify by membership in subsets of that value set.  NOTE: A patient\ncan belong to multiple strata in this example.</td><td>text/fhirpath</td><td>findAll('Condition',\n\tfor('patient', $this.subject),\n\twith('code').in(%AllCOVID19RiskFactors.url),\n       with('onset-date').greaterThan(%ReportingPeriod.start - 1 'year')\n   ).onServers(%Base).select(\n   \tiif(code.member0f(%NeoplasticCOVID19RiskFactors.url), 'Neoplastic Disease', {}) |\n   \tiif(code.member0f(%COPDCOVID19RiskFactors.url), 'COPD', {}) |\n   \tiif(code.member0f(%TobaccoCOVID19RiskFactors.url), 'Tobacco User', {}) |\n   \tiif(code.member0f(%HypertensionCOVID19RiskFactors.url), 'Hypertension', {}) |\t// Calling out Hypertension separately for reasons\n   \tiif(code.member0f(%CardiovascularCOVID19RiskFactors.url), 'Cardiovascular Disease', {}) |\t// Even though it isa Cardiovascular disease\n   \tiif(code.member0f(%ObesityCOVID19RiskFactors.url), 'Obesity', {}) |\n   \tiif(code.member0f(%SickleCellCOVID19RiskFactors.url), 'Sickle cell Disease', {}) |\n   \tiif(code.member0f(%KidneyDiseaseCOVID19RiskFactors.url), 'Chronic Kidney Disease', {}) |\n   \tiif(code.member0f(%PregnancyCOVID19RiskFactors.url), 'Pregnant', {}) |\n   \tiif(code.member0f(%DiabetesCOVID19RiskFactors.url), 'Diabetes', {})\n   )</td></tr></table></blockquote></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: Encounter <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#Encounter)</span></p><p><b>usage</b>: Supplemental Data <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-measure-data-usage.html\">MeasureDataUsage</a>#supplemental-data)</span></p><p><b>description</b>: The patient encounter</p><h3>Criteria</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Description</b></td><td><b>Name</b></td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td style=\"display: none\">*</td><td>Encounter dates, reason (e.g., Chief Complaint), discharge disposition</td><td>Encounter</td><td>text/fhirpath</td><td>Encounter</td></tr></table></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: Patient <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#Patient)</span></p><p><b>usage</b>: Supplemental Data <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-measure-data-usage.html\">MeasureDataUsage</a>#supplemental-data)</span></p><p><b>description</b>: The patient</p><h3>Criteria</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Description</b></td><td><b>Name</b></td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td style=\"display: none\">*</td><td>The Patient, including sex, dob, race and ethnicity</td><td>Patient</td><td>text/fhirpath</td><td>Encounter.subject.resolve()</td></tr></table></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: Location <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#Location)</span></p><p><b>usage</b>: Supplemental Data <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-measure-data-usage.html\">MeasureDataUsage</a>#supplemental-data)</span></p><p><b>description</b>: The patient location</p><h3>Criteria</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Description</b></td><td><b>Name</b></td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td style=\"display: none\">*</td><td>The Patient Location</td><td>PatientLocation</td><td>text/fhirpath</td><td>Encounter.location.location.resolve()</td></tr></table></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: Condition <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#Condition)</span></p><p><b>usage</b>: Supplemental Data <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-measure-data-usage.html\">MeasureDataUsage</a>#supplemental-data)</span></p><p><b>description</b>: The encounter and other diagnosis</p><h3>Criteria</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Description</b></td><td><b>Name</b></td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td style=\"display: none\">*</td><td>Retrieves all conditions associated with the encounter</td><td>EncounterDiagnosis</td><td>text/fhirpath</td><td>(Encounter.reasonReference|Encounter.diagnosis.condition).resolve() |\nfindAll('Condition',\n\tfor('patient', $this.subject),\n\twith('encounter').equalTo($this.id)\n).onServers(%Base)</td></tr></table></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: MedicationRequest <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#MedicationRequest; <a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#MedicationAdministration; <a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#Immunization)</span></p><p><b>usage</b>: Supplemental Data <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-measure-data-usage.html\">MeasureDataUsage</a>#supplemental-data)</span></p><p><b>description</b>: Medications/Immunizations given during the encounter</p><h3>Criteria</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Description</b></td><td><b>Name</b></td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td style=\"display: none\">*</td><td>Retrieves all medications/immunizations associated with the encounter</td><td>EncounterMeds</td><td>text/fhirpath</td><td>findAll('MedicationRequest',\n\tfor('patient', $this.subject),\n\twith('encounter').equalTo($this.id)  // alternately, this could be within encounter dates\n).onServers(%Base) |\nfindAll('MedicationAdministration',\n\tfor('patient', $this.subject),\n\twith('effective-time').within(%ReportingPeriod)\n).onServers(%Base) |\nfindAll('Immunization',\n\tfor('patient', $this.subject),\n\twith('date').within(%ReportingPeriod)\n).onServers(%Base)</td></tr></table></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: Observation <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#Observation)</span></p><p><b>usage</b>: Supplemental Data <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-measure-data-usage.html\">MeasureDataUsage</a>#supplemental-data)</span></p><p><b>description</b>: COVID-19 Lab Results</p><h3>Criteria</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Description</b></td><td><b>Name</b></td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td style=\"display: none\">*</td><td>Retrieves all Observations associated with COVID-19 Labs</td><td>COVID19Labs</td><td>text/fhirpath</td><td>findAll('Observation',\n\tfor('patient', $this.subject),\n\twith('code').in(%Covid19Labs.url),\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year')\n).onServers(%Base)</td></tr></table></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: DiagnosticReport <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#DiagnosticReport; <a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#DocumentReference; <a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#Observation; <a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#ServiceRequest)</span></p><p><b>usage</b>: Supplemental Data <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-measure-data-usage.html\">MeasureDataUsage</a>#supplemental-data)</span></p><p><b>description</b>: VTE Diagnostic Results</p><h3>Criteria</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Description</b></td><td><b>Name</b></td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td style=\"display: none\">*</td><td>Retrieves diagnostics associated with VTE</td><td>VTEDiagnostics</td><td>text/fhirpath</td><td>findAll('DiagnosticReport',\n\tfor('patient', $this.subject),\n\tincluding('result', 'media'), // what else?\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n\twith('code').in(%VTEReports.url)\n).onServers(%Base) |\nfindAll('DocumentReference',\n\tfor('patient', $this.subject),\n\tincluding('related'), // what else?\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n\twith('type').in(%VTEReports.url)\n).onServers(%Base) |\nfindAll('Observation',\n\tfor('patient', $this.subject),\n\tincluding('based-on'), // what else?\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n\twith('code').in(%VTEReports.url)\n).onServers(%Base) |\nfindAll('ServiceRequest',\n\tfor('patient', $this.subject),\n\tincluding('based-on'), // what else?\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n\twith('code').in(%VTEReports.url)\n).onServers(%Base)</td></tr></table></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: Procedure <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#Procedure; <a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#ServiceRequest)</span></p><p><b>usage</b>: Supplemental Data <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-measure-data-usage.html\">MeasureDataUsage</a>#supplemental-data)</span></p><p><b>description</b>: Isolation Precautions</p><h3>Criteria</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Description</b></td><td><b>Name</b></td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td style=\"display: none\">*</td><td>Retrieves orders or procedures associated with Isolation Precautions</td><td>IsolationOrders</td><td>text/fhirpath</td><td>findAll('ServiceRequest',\n\tfor('patient', $this.subject),\n\tfor('encounter', $this.id),\n\twith('code').in(%IsolationPrecautions.url)\n).onServers(%Base) |\nfindAll('Procedure',\n\tfor('patient', $this.subject),\n\tfor('encounter', $this.id),\n\twith('code').in(%IsolationPrecautions.url)\n).onServers(%Base)</td></tr></table></blockquote></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/uv/saner/StructureDefinition/ReportingPeriod",
      "valueTiming" : {
        "repeat" : {
          "frequency" : 1,
          "period" : 1,
          "periodUnit" : "d"
        }
      }
    }
  ],
  "url" : "http://hl7.org/fhir/uv/saner/Measure/PatientsByRiskFactorWithSupplementalData",
  "identifier" : [
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:2.16.840.1.113883.4.642.40.42.29.6"
    }
  ],
  "version" : "1.0.1",
  "name" : "PatientsByRiskFactor",
  "title" : "COVID-19 Patients By Risk Factor",
  "status" : "draft",
  "experimental" : true,
  "date" : "2024-05-18T21:25:01+00:00",
  "publisher" : "HL7 International / Public Health",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/pher"
        }
      ]
    },
    {
      "telecom" : [
        {
          "system" : "email",
          "value" : "pher@lists.hl7.org"
        }
      ]
    },
    {
      "name" : "Keith W. Boone",
      "telecom" : [
        {
          "system" : "email",
          "value" : "mailto:kboone@ainq.com"
        }
      ]
    }
  ],
  "description" : "This measure demonstrates automated reporting of patients with COVID-19 stratified by condition, and reporting supplemental data",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "840539006",
            "display" : "COVID-19"
          }
        ]
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code" : "001",
          "display" : "World"
        }
      ]
    }
  ],
  "author" : [
    {
      "name" : "Centers for Disease Control/National Healthcare Safety Network (CDC/NHSN)",
      "telecom" : [
        {
          "system" : "email",
          "value" : "mailto:nhsn@cdc.gov"
        }
      ]
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "documentation",
      "label" : "NHSN COVID-19 Reporting",
      "display" : "CDC/NHSN COVID-19 Patient Impact & Hospital Capacity Module Home Page",
      "url" : "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/acute-care-hospital/covid19/",
      "document" : {
        "url" : "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/acute-care-hospital/covid19/"
      }
    },
    {
      "type" : "documentation",
      "label" : "How to import COVID-19 Summary Data",
      "display" : "Importing COVID-19 Patient Module Denominator data for Patient Safety Component",
      "url" : "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/import-covid19-data-508.pdf",
      "document" : {
        "url" : "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/import-covid19-data-508.pdf"
      }
    },
    {
      "type" : "documentation",
      "label" : "Table of Instructions",
      "display" : "Instructions for Completion of the COVID-19 Patient Impact and Hospital Capacity Module Form (CDC 57.130)",
      "url" : "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/57.130-toi-508.pdf",
      "document" : {
        "url" : "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/57.130-toi-508.pdf"
      }
    },
    {
      "type" : "documentation",
      "label" : "CSV File Template",
      "display" : "CDC/NHSN COVID-19 Reporting CSV File Template",
      "url" : "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/covid19-test-csv-import.csv",
      "document" : {
        "url" : "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/covid19-test-csv-import.csv"
      }
    }
  ],
  "library" : [
    🔗 "http://hl7.org/fhir/uv/saner/Library/ComputableNHSNMeasureLibrary"
  ],
  "group" : [
    {
      "extension" : [
        {
          "extension" : [
            {
              "url" : "subject",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/resource-types",
                    "code" : "Encounter"
                  },
                  {
                    "system" : "http://snomed.info/sct",
                    "code" : "398284004",
                    "display" : "Patient in room"
                  }
                ],
                "text" : "Patient in room"
              }
            },
            {
              "url" : "scoring",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/uv/saner/CodeSystem/PublicHealthMeasureScoring",
                    "code" : "queue-length"
                  }
                ]
              }
            },
            {
              "url" : "type",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-type",
                    "code" : "structure"
                  }
                ]
              }
            },
            {
              "url" : "improvementNotation",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
                    "code" : "decrease"
                  }
                ]
              }
            },
            {
              "url" : "rateAggregation",
              "valueString" : "point-in-time"
            }
          ],
          "url" : "http://hl7.org/fhir/uv/saner/StructureDefinition/MeasureGroupAttributes"
        }
      ],
      "code" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/uv/saner/CodeSystem/MeasureGroupSystem",
            "code" : "Encounters",
            "display" : "Encounters"
          }
        ],
        "text" : "Hospital COVID-19 Patient Encounters Reporting"
      },
      "population" : [
        {
          "code" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/uv/saner/CodeSystem/MeasuredValues",
                "code" : "confirmedC19Pats",
                "display" : "All Confirmed COVID-19 Patients"
              },
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "initial-population"
              }
            ],
            "text" : "Patients with confirmed COVID-19 in any location."
          },
          "description" : "Active encounters where the encounter diagnosis is suspected or confirmed COVID-19,\nor a Condition of confirmed COVID-19 was created during that encounter.  This includes the patients with laboratory-confirmed\nor clinically diagnosed COVID-19.",
          "criteria" : {
            "description" : "This expression finds encounters that were active or finished in the reporting period, and their referenced Patient, Condition\nand Observation resources. It filters these based on cases where Encounter reports a reason or condition in the\nConfirmedCOVID19Diagnoses value set, or where a positive lab test from the Covid19Labs valueset, or where the patient\nhas any such associated Condition or Observation resources in the prior two weeks.",
            "name" : "ConfirmedC19Pats",
            "language" : "text/fhirpath",
            "expression" : "findAll('Encounter',\n    including('subject','condition','reasonReference'),\n    with('status').equalTo('in-progress,finished'),\n    with('date').within(%ReportingPeriod)\n ).onServers(%Base).\n where(\n   iif(\n     (Encounter.reasonCode | Condition.code).member0f(%ConfirmedCOVID19Diagnoses.url) |\n     Observation.where(code.member0f(%Covid19Labs.url) and value.member0f(%PositiveResults.url)),\n     true,\n     iif(\n       Patient.distinct()\n          .whereExists('Observation',\n            for('patient', $this.id),\n            with('status').equalTo(\n                'registered,preliminary,final,amended,corrected'),\n            with('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n            with('code').in(%Covid19Labs),\n            with('value-concept').in(%PositiveResults)\n       ).onServers(%Base),\n       true,\n       Patient.distinct()\n          .whereExists('Condition',\n            for('patient', $this.id),\n            with('verification-status').notEqualTo('refuted,entered-in-error').\n            with('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n            with('code').in(%ConfirmedCOVID19Diagnoses.url)\n       ).onServers(%Base)\n     )\n  )\n)\n.ofType(Encounter)\n.distinct()\n.aggregate(\n  iif($total.subject contains $this.subject, $total, $total | $this )\n)"
          }
        }
      ],
      "stratifier" : [
        {
          "code" : {
            "text" : "By Risk Factor"
          },
          "description" : "Stratifies the population by Condition/RiskFactor",
          "criteria" : {
            "description" : "Final all conditions for each patient in the AllCOVID19RiskFactors ValueSet\nand stratify by membership in subsets of that value set.  NOTE: A patient\ncan belong to multiple strata in this example.",
            "language" : "text/fhirpath",
            "expression" : "findAll('Condition',\n\tfor('patient', $this.subject),\n\twith('code').in(%AllCOVID19RiskFactors.url),\n       with('onset-date').greaterThan(%ReportingPeriod.start - 1 'year')\n   ).onServers(%Base).select(\n   \tiif(code.member0f(%NeoplasticCOVID19RiskFactors.url), 'Neoplastic Disease', {}) |\n   \tiif(code.member0f(%COPDCOVID19RiskFactors.url), 'COPD', {}) |\n   \tiif(code.member0f(%TobaccoCOVID19RiskFactors.url), 'Tobacco User', {}) |\n   \tiif(code.member0f(%HypertensionCOVID19RiskFactors.url), 'Hypertension', {}) |\t// Calling out Hypertension separately for reasons\n   \tiif(code.member0f(%CardiovascularCOVID19RiskFactors.url), 'Cardiovascular Disease', {}) |\t// Even though it isa Cardiovascular disease\n   \tiif(code.member0f(%ObesityCOVID19RiskFactors.url), 'Obesity', {}) |\n   \tiif(code.member0f(%SickleCellCOVID19RiskFactors.url), 'Sickle cell Disease', {}) |\n   \tiif(code.member0f(%KidneyDiseaseCOVID19RiskFactors.url), 'Chronic Kidney Disease', {}) |\n   \tiif(code.member0f(%PregnancyCOVID19RiskFactors.url), 'Pregnant', {}) |\n   \tiif(code.member0f(%DiabetesCOVID19RiskFactors.url), 'Diabetes', {})\n   )"
          }
        }
      ]
    }
  ],
  "supplementalData" : [
    {
      "code" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/resource-types",
            "code" : "Encounter"
          }
        ]
      },
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "The patient encounter",
      "criteria" : {
        "description" : "Encounter dates, reason (e.g., Chief Complaint), discharge disposition",
        "name" : "Encounter",
        "language" : "text/fhirpath",
        "expression" : "Encounter"
      }
    },
    {
      "code" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/resource-types",
            "code" : "Patient"
          }
        ]
      },
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "The patient",
      "criteria" : {
        "description" : "The Patient, including sex, dob, race and ethnicity",
        "name" : "Patient",
        "language" : "text/fhirpath",
        "expression" : "Encounter.subject.resolve()"
      }
    },
    {
      "code" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/resource-types",
            "code" : "Location"
          }
        ]
      },
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "The patient location",
      "criteria" : {
        "description" : "The Patient Location",
        "name" : "PatientLocation",
        "language" : "text/fhirpath",
        "expression" : "Encounter.location.location.resolve()"
      }
    },
    {
      "code" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/resource-types",
            "code" : "Condition"
          }
        ]
      },
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "The encounter and other diagnosis",
      "criteria" : {
        "description" : "Retrieves all conditions associated with the encounter",
        "name" : "EncounterDiagnosis",
        "language" : "text/fhirpath",
        "expression" : "(Encounter.reasonReference|Encounter.diagnosis.condition).resolve() |\nfindAll('Condition',\n\tfor('patient', $this.subject),\n\twith('encounter').equalTo($this.id)\n).onServers(%Base)"
      }
    },
    {
      "code" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/resource-types",
            "code" : "MedicationRequest"
          },
          {
            "system" : "http://hl7.org/fhir/resource-types",
            "code" : "MedicationAdministration"
          },
          {
            "system" : "http://hl7.org/fhir/resource-types",
            "code" : "Immunization"
          }
        ]
      },
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "Medications/Immunizations given during the encounter",
      "criteria" : {
        "description" : "Retrieves all medications/immunizations associated with the encounter",
        "name" : "EncounterMeds",
        "language" : "text/fhirpath",
        "expression" : "findAll('MedicationRequest',\n\tfor('patient', $this.subject),\n\twith('encounter').equalTo($this.id)  // alternately, this could be within encounter dates\n).onServers(%Base) |\nfindAll('MedicationAdministration',\n\tfor('patient', $this.subject),\n\twith('effective-time').within(%ReportingPeriod)\n).onServers(%Base) |\nfindAll('Immunization',\n\tfor('patient', $this.subject),\n\twith('date').within(%ReportingPeriod)\n).onServers(%Base)"
      }
    },
    {
      "code" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/resource-types",
            "code" : "Observation"
          }
        ]
      },
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "COVID-19 Lab Results",
      "criteria" : {
        "description" : "Retrieves all Observations associated with COVID-19 Labs",
        "name" : "COVID19Labs",
        "language" : "text/fhirpath",
        "expression" : "findAll('Observation',\n\tfor('patient', $this.subject),\n\twith('code').in(%Covid19Labs.url),\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year')\n).onServers(%Base)"
      }
    },
    {
      "code" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/resource-types",
            "code" : "DiagnosticReport"
          },
          {
            "system" : "http://hl7.org/fhir/resource-types",
            "code" : "DocumentReference"
          },
          {
            "system" : "http://hl7.org/fhir/resource-types",
            "code" : "Observation"
          },
          {
            "system" : "http://hl7.org/fhir/resource-types",
            "code" : "ServiceRequest"
          }
        ]
      },
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "VTE Diagnostic Results",
      "criteria" : {
        "description" : "Retrieves diagnostics associated with VTE",
        "name" : "VTEDiagnostics",
        "language" : "text/fhirpath",
        "expression" : "findAll('DiagnosticReport',\n\tfor('patient', $this.subject),\n\tincluding('result', 'media'), // what else?\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n\twith('code').in(%VTEReports.url)\n).onServers(%Base) |\nfindAll('DocumentReference',\n\tfor('patient', $this.subject),\n\tincluding('related'), // what else?\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n\twith('type').in(%VTEReports.url)\n).onServers(%Base) |\nfindAll('Observation',\n\tfor('patient', $this.subject),\n\tincluding('based-on'), // what else?\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n\twith('code').in(%VTEReports.url)\n).onServers(%Base) |\nfindAll('ServiceRequest',\n\tfor('patient', $this.subject),\n\tincluding('based-on'), // what else?\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n\twith('code').in(%VTEReports.url)\n).onServers(%Base)"
      }
    },
    {
      "code" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/resource-types",
            "code" : "Procedure"
          },
          {
            "system" : "http://hl7.org/fhir/resource-types",
            "code" : "ServiceRequest"
          }
        ]
      },
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "Isolation Precautions",
      "criteria" : {
        "description" : "Retrieves orders or procedures associated with Isolation Precautions",
        "name" : "IsolationOrders",
        "language" : "text/fhirpath",
        "expression" : "findAll('ServiceRequest',\n\tfor('patient', $this.subject),\n\tfor('encounter', $this.id),\n\twith('code').in(%IsolationPrecautions.url)\n).onServers(%Base) |\nfindAll('Procedure',\n\tfor('patient', $this.subject),\n\tfor('encounter', $this.id),\n\twith('code').in(%IsolationPrecautions.url)\n).onServers(%Base)"
      }
    }
  ]
}