This statement defines the expected capabilities of a system that aggregates data from multiple Data Source actors before measure evaluation and then plays the role of a Data Source once aggregation is complete. An example would be a state public health agency aggregating data from all facilities in the state before using those data to produce a MeasureReport containing bed capacity data for the entire state. When FHIR enabled, a Data Aggregator acts as a US Core Server when playing the role of a Data Source after aggregation. During aggregation, the Data Aggregator acts similar to the SANER options for aggregation, but implements its own CapabilityStatement due to the incompatibilities between DEQM and SANER.

This statement defines the expected capabilities of a system that retrieves data from the Data Source and evaluates those data against one or more measures retrieved from the Measure Source. The resulting MeasureReport bundle and related resources are then sent to the MeasureReport recipient The dQM Evaluation Engine acts as a US Core Client, a DEQM Reporter Client, and implements the $evaluation-measure operation

This statement defines the expected capabilities of a system containing data (typically patient data, but could be situational awareness data) that will be evaluated against one or more measures. This may be a FHIR server, an EHR with a FHIR endpoint (facade), an internal data store when the Data Source and dQM Evaluation Engine actors are played by the same system such as an EHR that does it’s own measure evaluation, or it may be a system containing other data such as situational awareness data that is reporting via CSV or other format. When FHIR enabled, the Data Source acts as a US Core Server

This statement defines the expected capabilities of a system at NHSN that stores FHIR resources such as Measure, Library, ValueSet, etc. that are used for dQM Reporting. The dQM Evaluation Engine queries the Measure Source for the latest Measure content before querying the Patient Data Source and performing measure evaluation. The Measure Source acts as a DEQM Publishable Measure Repository.

This statement defines the expected capabilities of a system at NHSN that receives MeasureReport bundles from the dQM Evaluation Engine and validates the result against the profiles in this implementation guide, and potentially other measure-specific profiles that are distributed with the measures themselves (this kind of validation is referred to as “pre-qualification” at NHSN). The MeasureReport Recipient acts as a DEQM Receiver Server, provides write access to Bundle resources containing MeasureReport and other related resources, and implements the $validate operation.

This profile defines a Bundle provided by the MeasureServer containing a Measure resource and all related resources (ValueSet, Library, etc.).

This profile defines a valid Submission Bundle to NHSN with all resources contained within. The Bundle is comprised of entry slices representing the data source Organization, a Patients of Interest (POI) List, one Subject List MeasureReport per reportable measure, an Individual MeasureReport List, individual MeasureReports, and the underlying patient-centric clinical information.

This profile includes the name and version of the device or software submitting the report Bundle, and may include other information about the device.

This profile includes the name and identifier of the organization submitting the report Bundle, and may include other information about the organization.

A Patients of Interest List defines all individual Patients considered for inclusion in NHSN Measure reporting.

Acute Care Hospital Encounter Class ValueSet

Acute Care Hospital Encounter Status ValueSet

This CodeSystem defines coded concepts for Healthcare Capacity reporting to NHSN. This CodeSystem is experimental, and is expected to be replaced by LOINC codes once they have been assigned.

Example Library of Acute Care Hospital (ACH) Initial Population Measure

The Acute Care Hospital (ACH) Initial Population includes all encounters for patients of any age in an ED, observation, or inpatient location or all encounters for patients of any age with an ED, observation, inpatient, or short stay status during the measurement period.

Example Library of Bed Capacity Measure

Condition - Example Diagnosis ACH Pass1 - Encounter Diagnosis: Bacteremia

Condition - Example Diagnosis ACH Pass2 - Encounter Diagnosis: Thrombophlebitis of deep femoral vein

Condition - Example Diagnosis ACH Pass2 - Problem List: Type 2 diabetes mellitus without complications

Condition - Example Diagnosis ACH Pass3 - Encounter Diagnosis: Enterocolitis due to Clostridium difficile

Condition - Example Diagnosis ACH Pass3 - Problem List: Acute sinusitis

Coverage - Example ACH Pass1 - Medicaid: Child Beneficiary

Coverage - Example ACH Pass2 - Commercial HMO

Coverage - Example ACH Pass3 - Commercial PPO

Device - Example ACH Pass1 - Central venous catheter

Device - Example ACH Pass2 - Graduated compression elastic hosiery

Device - Example ACH Pass3 - Intermittent venous compression system pump

Device - Submitting Device Example 1

DiagnosticReport - Example ACH Pass2 - Cardiovascular stress testing

DiagnosticReport - Example ACH Pass2 - CBC panel - Blood by Automated count

DiagnosticReport - Example ACH Pass2 - Ultrasonography of right lower limb

Effective - Data Requirements

Encounter - Example ACH Pass1 - Hospital Admission

Encounter - Example ACH Pass2 - Emergency department visit

Encounter - Example ACH Pass2 - Hospital admission

Encounter - Example ACH Pass3 - Acute critical care visit

Encounter - Example ACH Pass3 - Hospital admission short stay

Measure Bundle - Full Submission Bundle Example 1

Example Bundle of jurisidictional report for capacity reporting

List - Example ACH Individual Measure Report List Example

List - Example ACH Patients Of Interest

List - Patients of Interest Example 1

Location - Example ACH - Medical Critical Care

Location - Example ACH - Emergency Department

Location - Example ACH - Inpatient Hospital Ward

Location - Example ACH - Medical-Surgical Ward

Location - Example ACH - Neonatal Critical Care (Level III)

Example MeasureReport - Children’s Hospital Bed Capacity Individual Measure Report

Measure Report - Example ACH Subject List Example 1

MeasureReport - Example Individual ACH Pass1 - Late Onset Sepsis and Meningitis (LOS/MEN)

MeasureReport - Example Individual ACH Pass2 - Hypoglycemia

MeasureReport - Example Individual ACH Pass3 - Healthcare facility-onset, antibiotic-treated Clostridioides difficile infection / Hospital-onset bacteremia and fungemia (CDI/HOB)

Example MeasureReport - Hospital Bed Capacity Individual Measure Report

Example MeasureReport - Inpatient Psychiatric Facility Bed Capacity Individual Measure Report

Medication - Example - Ciprofloxacin 500 MG

Medication - Example - Metformin hydrochloride 1000 MG

Medication - Example - Enoxaparin sodium, 0.4 ML, 100 MG/ML Prefilled Syringe

Medication - Example - Heparin sodium, 0.5 ML, porcine 10000 UNT/ML Prefilled Syringe

Medication - Example - Insulin lispro

Medication - Example - Metformin hydrochloride 1000 MG

Medication - Example - Metronidazole 500 MG

Medication - Example - Vancomycin Injectable Solution

MedicationAdministration - Example ACH Pass1 - Vancomycin Injectable Solution 50MG

MedicationAdministration - Example ACH Pass2 - Dex4 4 gm chewable tablet X1

MedicationAdministration - Example ACH Pass2 - heparin sodium, 0.5 ML, porcine 10000 UNT/ML Prefilled Syringe - First Encounter Administration

MedicationAdministration - Example ACH Pass2 - heparin sodium, 0.5 ML, porcine 10000 UNT/ML Prefilled Syringe - Second Encounter Administration

MedicationAdministration - Example ACH Pass2 - Insulin Lispro - First Encounter Administration

MedicationAdministration - Example ACH Pass2 - Insulin Lispro - Second Encounter Administration

MedicationAdministration - Example ACH Pass2 - Insulin Lispro - Third Encounter Administration

MedicationAdministration - Example ACH Pass2 Insulin Lispro 4

MedicationAdministration - Example ACH Pass3 - Enoxaparin sodium, 0.4 ML, 100 MG/ML Prefilled Syringe

MedicationAdministration - Example ACH Pass3 - Metronidazole 500 MG - First Encounter Administration

MedicationAdministration - Example ACH Pass3 - Metronidazole 500 MG - Second Encounter Administration

MedicationAdministration - Example ACH Pass3 - Metronidazole 500 MG - Third Encounter Administration

MedicationRequest - Example ACH Pass1 - Vancomycin Injectable Solution 50MG

MedicationRequest - Example ACH Pass2 - Dex4 4 gm chewable tablet X1

MedicationRequest - Example ACH Pass2 - heparin sodium, 0.5 ML, porcine 10000 UNT/ML Prefilled Syringe

MedicationRequest - Example ACH Pass2 - Insulin Lispro

MedicationRequest - Example ACH Pass2 - Metformin hydrochloride 1000 MG

MedicationRequest - Example ACH Pass3 - Ciprofloxacin 500 MG

MedicationRequest - Example ACH Pass3 - enoxaparin sodium, 0.4 ML, 100 MG/ML Prefilled Syringe

MedicationRequest - Example ACH Pass3 - Metronidazole 500 MG

NHSN bed capacity example measure

Observation - Example ACH Pass1 - Lab: Bacteria identified in Blood by Culture

Observation - Example ACH Pass1 - Lab: Serratia marcescens DNA in Specimen by NAA with probe detection

Observation - Example ACH Pass1 - Lab: Gestational age at birth

Observation - Example ACH Pass1 - Vitals Signs: Birth weight Measured

Observation - Example ACH Pass2 - Lab: Bacteria identified in Blood by Culture

Observation - Example ACH Pass2 Hemo - Lab: Glucose in Capillary blood by Glucometer

Observation - Example ACH Pass2 Lab: Glucose in Capillary blood by Glucometer - First Encounter Observation

Observation - Example ACH Pass2 Lab: Glucose in Capillary blood by Glucometer - Second Encounter Observation

Observation - Example ACH Pass2 Vitals Signs: Body weight

Observation - Example ACH Pass2 Lab: aPTT in Blood by Coagulation assay

Observation - Example ACH Pass3 - Lab: Clostridioides difficile (C. diff)

Observation - Example ACH Pass3 Vitals Signs: Body height

Observation - Example ACH Pass3 Vitals Signs: Body weight

Organization - Submitting Organization Example

Patient - Example ACH Pass1 - Late Onset Sepsis and Meningitis (LOS/MEN)

Patient - Example ACH Pass2 - Hypoglycemia

Patient - Example ACH Pass3 - Healthcare facility-onset, antibiotic-treated Clostridioides difficile infection / Hospital-onset bacteremia and fungemia (CDI/HOB)

Patient - Example Sameresultdiffday - Hypoglycemia

An example practitioner

Procedure - Example ACH Pass1 - Placement procedure

Procedure - Example ACH Pass1 - Drainage of Spinal Canal, Percutaneous Approach, Diagnostic

Procedure - Example ACH Pass2 - Percutaneous insertion of inferior vena cava filter

Procedure - Example ACH Pass3 - Transfusion of red blood cells

ServiceRequest - Example ACH Pass1 Blood

ServiceRequest - Example ACH Pass1 - Differential panel - Cerebral spinal fluid

ServiceRequest - Example ACH Pass2 - Glucose in Capillary blood by Glucometer

ServiceRequest - Example ACH Pass2 - Hemoglobin in Venous blood

ServiceRequest - Example ACH Pass2 Hemo - Hemoglobin A1c in Blood

ServiceRequest - Example ACH Pass2 - aPTT in Blood by Coagulation assay

ServiceRequest - Example ACH Pass3 - Clostridioides difficile toxin A in Stool by Immunoassay

Specimen - Example ACH Pass1 - Blood venous from heel

Specimen - Example ACH Pass1 - Cerebral spinal fluid from superior articular process of lumbar vertebra

Specimen - Example ACH Pass2 - Blood venous from blood vessel of left upper arm - First encounter collection

Specimen - Example ACH Pass2 - Blood venous from blood vessel of left upper arm - Second encounter collection

Specimen - Example ACH Pass3 - Bloody stool

Example of a Software System Device instance for describing tooling that was used to process artifacts.