QI-Core Implementation Guide: STU 4 (v4.0.0 for FHIR 4.0.0)

QI-Core Implementation Guide, Clinical Quality Improvement WG - CI build for vesion 4.0.0). This version is based on the current content of https://github.com/cqframework/qi-core/ and changes regularly. See the Directory of published versions

7.3.0 Assessment

This QDM to QI Core Mapping for the QDM Category "Assessment" was reviewed by the CQI WG on March 9, 2018 for QDM version 5.3 and updated to QDM 5.4 on June 7, 2018. QDM 5.4 added the QDM datatype "Assessment, Order" that was not present in QDM version 5.3. In QDM 5.4, the "method" attribute has been removed from "Assessment, Order" and "Assessment, Recommended" but is retained for "Assessment, Performed".

QDM defines Assessment as a resource used to define specific observations that clinicians use to guide treatment of the patient. An assessment can be a single question, or observable entity with an expected response, an organized collection of questions intended to solicit information from patients, providers or other individuals, or a single observable entity that is part of such a collection of questions. US-Core defines a specific resource for smoking status assessment; other observations that meet the QDM definition of assessment use the FHIR Observation resource:

7.3.1 Assessment, Performed

QDM Context QI-Core R4 Comments
Assessment, Performed Observation General Use Case
Observation.category Since Assessment is a broad concept, the measure developer will need to select the appropriate category.
Observation.status Constrain status to - final, amended, corrected
QDM Attributes
code Observation.code
id Observation.id
method Observation.method
relatedTo Observation.basedOn
Observation.partOf A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.
Observation.derivedFrom
negation rationale Observation.dataAbsentReason Initial table indicates extensible but detailed link indicates SHALL - https://build.fhir.org/ig/HL7/US-Core-R4/StructureDefinition-us-core-observation-lab-definitions.html#Observation.dataAbsentReason
reason Observation.basedOn The observation fulfills a plan, proposal or order - trace for authorization. Not a perfect fit for the intent in QDM (e.g., observation "reason" = a diagnosis) Is an extension needed?
result Observation.value[x]
Observation.interpretation
Relevant dateTime Observation.effective[x] dateTime
Relevant Period Observation.effective[x] Period
Author dateTime Observation.issued Consider if authorDatetime (intended for negation rationale) fits with observation.issued or FHIR provenance for docuemtnation of the dataAbsentReason.
Component Observation.component
Observation.component.id
Component code Observation.component.code
Component Result Observation.component.value[x]
Observation.component.interpretation
Observation.component.dataAbsentReason
Performer Observation.performer

7.3.2 Assessment, Performed: Smoking Status

QDM Context USCore R4 Comments
Assessment, Performed: Smoking Status Observation Modeled as in USCore - Smoking Status
Observation.status Constrain status to - final, amended, corrected
QDM Attributes
code Observation.code Fixed LOINC code 72166-2
id Observation.id
method Observation.method
relatedTo Observation.basedOn
negation rationale Observation.dataAbsentReason
reason
result Observation.valueCodeableConcept
Relevant dateTime Observation.effective[x]
Relevant Period Observation.effective[x]
Author dateTime  Observation.issued Consider if authorDatetime (intended for negation rationale) fits with observation.issued or FHIR provenance for docuemtnation of the dataAbsentReason.
Component Observation.component
Observation.component.id
Component code Observation.component.code
Component result Observation.component.value[x]
Observation.component.dataAbsentReason
Performer Observation.performer

7.3.3 Assessment, Order

To address the QDM attribute Assessment, Order see Service Request

7.3.4 Assessment, Recommended

To address the QDM attribute Assessment, Recommended see Service Request