2026 US Quality Core Implementation Guide
0.5.0 - cibuild US

2026 US Quality Core Implementation Guide, published by Office of the National Coordinator for Health Information Technology (ONC). This guide is not an authorized publication; it is the continuous build for version 0.5.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/FHIR/us-quality-core/ and changes regularly. See the Directory of published versions

## : Communication negation example - XML Representation

Raw xml | Download

    <Communication xmlns="http://hl7.org/fhir">
      <id value="negation-example"/>
      <meta>
        <profile
                 value="http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-communicationnotdone"/>
      </meta>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Communication negation-example</b></p><a name="negation-example"> </a><a name="hcnegation-example"> </a><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"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-us-quality-core-communicationnotdone.html">US Quality Core Communication Not Done</a></p></div><p><b>US Quality Core Not Done Recorded</b>: 2014-12-12 18:01:10-0800</p><p><b>status</b>: Not Done</p><p><b>statusReason</b>: <span title="Codes:">Patient moved away and could not be reached</span></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/communication-category alert}">Alert</span></p><p><b>medium</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-ParticipationMode WRITTEN}">written</span></p><p><b>subject</b>: <a href="Patient-example.html">Jim Chalmers  Male, DoB: 1974-12-25 ( Social Security number (use: usual, period: 2001-05-06 --&gt; (ongoing)))</a></p><p><b>topic</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/communication-topic progress-update}">Progress Update</span></p><p><b>encounter</b>: <a href="Encounter-example.html">Encounter: identifier = http://example.org/encounters#ENC-20130404-appendicitis; status = finished; class = inpatient encounter (v3 Code System ActCode#IMP); type = Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.; period = 2013-04-04 18:00:00-0400 --&gt; 2013-04-06 11:00:00-0400</a></p><p><b>recipient</b>: <a href="Patient-example.html">Jim Chalmers  Male, DoB: 1974-12-25 ( Social Security number (use: usual, period: 2001-05-06 --&gt; (ongoing)))</a></p><p><b>sender</b>: <a href="Practitioner-example.html">Practitioner Adam Careful </a></p><h3>Payloads</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Content[x]</b></td></tr><tr><td style="display: none">*</td><td>Patient could not be reached to discuss follow-up care after moving away.</td></tr></table></div>
      </text>
      <extension
                 url="http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-recorded">
        <valueDateTime value="2014-12-12T18:01:10-08:00"/>
      </extension>
      <status value="not-done"/>
      <statusReason>
        <text value="Patient moved away and could not be reached"/>
      </statusReason>
      <category>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/communication-category"/>
          <code value="alert"/>
        </coding>
        <text value="Alert"/>
      </category>
      <medium>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/v3-ParticipationMode"/>
          <code value="WRITTEN"/>
          <display value="written"/>
        </coding>
        <text value="written"/>
      </medium>
      <subject>🔗
        <reference value="Patient/example"/>
      </subject>
      <topic>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/communication-topic"/>
          <code value="progress-update"/>
          <display value="Progress Update"/>
        </coding>
      </topic>
      <encounter>🔗
        <reference value="Encounter/example"/>
      </encounter>
      <recipient>🔗
        <reference value="Patient/example"/>
      </recipient>
      <sender>🔗
        <reference value="Practitioner/example"/>
      </sender>
      <payload>
        <contentString
                       value="Patient could not be reached to discuss follow-up care after moving away."/>
      </payload>
    </Communication>