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Example OperationDefinition/Measure-care-gaps (Narrative)

Clinical Quality Information Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: No defined compartments

This is the narrative for the resource. See also the XML, JSON or Turtle format.

Note that this is the formal definition for the care-gaps operation as an OperationDefinition on Measure. See the Operation documentation


Generated Narrative: OperationDefinition Measure-care-gaps

URL: [base]/Measure/$care-gaps

URL: [base]/Measure/[id]/$care-gaps

Parameters

UseNameScopeCardinalityTypeBindingDocumentation
IN periodStart 1..1 date

The start of a gaps through period. This may be the start of the measurement period defined by a measure, or a customized desired performance period start date determined by a payer, a provider, a measure program, and etc.

IN periodEnd 1..1 date

The end of a gaps through period (the gaps through date). The gaps through date could be a past date or a future date. For example, today's date is 2020-06-18, 1) if periodEnd date is 2020-09-30, it returns gaps through 2020-09-30, and 2) if the periodEnd date is 2020-05-31, it returns gaps through 2020-05-31.

IN subject 0..1 string
(reference)

Subject for which the care gaps report will be produced

IN subjectGroup 0..1 Group

Subject for which the gaps in care report will be created is provided as a Group resource.

IN parameters 0..1 Parameters

Any input parameters for the Measure evaluation. If the measure uses CQL, the parameter types are mapped to CQL as specified in the Parameters and Data Requirements section of the Using CQL with FHIR Implementation Guide. Any parameters defined in this input will be bound by name to parameters defined in the logic library referenced from library element of the Measure. If a parameter appears more than once in the input Parameters resource, it is represented with a List in the input CQL. If a parameter has parts, it is represented as a Tuple in the input CQL.

IN practitioner 0..1 string
(reference)

Reference to a Practitioner for which the gaps in care report will be created. For a practitioner focused gaps in care report, this is a required In Parameter. The Server needs to make sure that practitioner is authorized to get the gaps in care report for and know what measures the practitioner are eligible or qualified.

IN organization 0..1 string
(reference)

Reference to an Organization for which the gaps in care report will be created. Either 'organization' or 'organizationResource' SHALL be provided, but not both.

IN organizationResource 0..1 Organization

Organization for which the gaps in care report will be created is provided as an Organization resource. Either 'organization' or 'organizationResource' SHALL be provided, but not both.

IN status 1..* code

Indicates status of a care gap. For all [open, closed, and prospective gaps], three seperate status parameters must be provided. For a positive proportion measure, gap means the patient is not in the numerator. For an inverse (negative) proportion measure (e.g., Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%)), gap means the patient is in the numerator.

IN measureId 0..* id

The id of a Measure resource that is on the server for which the gaps in care report will be created. E.g., the id of the Measure resource for Breast Cancer Screening measure.

IN measureIdentifier 0..* string
(token)

The business identifier of a measure for which the gaps in care will be reported. E.g., CMS125 is a CMS assigned identifier for the Breast Cancer Screening eCQM in their system. Note that the type of this parameter is a string with a search type of token, so the $care-gaps operation has only simple input parameters and may be invoked using GET.

IN measureUrl 0..* canonical

The URL of a measure for which the gaps in care report will be created. A measure URL is specified in the url element of the Measure resource. The measure URL remains the same when the measure is stored on different servers.

IN measureResource 0..* Measure

The measure for which the gaps in care report will be created is provided as a Measure resource.

IN measure 0..* string
(reference)

The measure for which the gaps in care report will be created. This parameter is only required when the operation is invoked on the resource type, it is not used when invoking the operation on a Measure instance

IN manifest 0..1 canonical

Specifies an asset-collection library that provides dependency version resolution and expansion rules for the operation. See the description of manifest in the Canonical Resource Management Infrastructure IG for a complete description of how manifest values are used to provide defaults for dependency version resolution and expansion parameters. Parameters specified directly in the operation override behaviors specified by the manifest parameter. In general, if this parameter is supplied, it is expected to be used in nested operation calls. For example, in evaluating a measure, if the expansion of a value set is required, this parameter SHALL be supplied to that expansion.

IN isDocument 0..1 boolean

The isDocument parameter controls whether a Gaps in Care Composition is returned in the Bundle (i.e. if the Bundle is of type 'Document'). When 'true,' the returned Bundles contain the Gaps in Care Composition. This parameter defaults to 'true.'

OUT return 0..* Bundle

The $care-gaps operation returns zero or more document Bundles, one for each input subject. Consistent with FHIR Documents generally, each Bundle SHALL have a Composition as the first entry in the document Bundle, and that Composition SHALL be limited to a single subject. See the guidance on Bundle structure for discussion about the Bundle content and organization. Note that even though there is a single parameter named return of type Bundle, it is a multi-cardinality parameter, and so will still be returned using a Parameters resource, as described in the general operations framework https://hl7.org/fhir/R4/operations.html#response.

The effect of invoking this operation is to calculate a set of measures for a particular topic (e.g. Preventive Care and Screening) and return a document describing the results of each measure for the given subject. Note that it is up to the server to determine whether or not the generated care gaps report is persisted. If the server does not persist the results, the operation does not affect state and can be invoked with a GET


 

 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.