Data Exchange For Quality Measures Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 5.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-deqm/ and changes regularly. See the Directory of published versions
Official URL: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-detectedissue-deqm | Version: 5.0.0 | |||
Active as of 2021-04-23 | Computable Name: DEQMGapsInCareDetectedIssueProfile | |||
Other Identifiers: OID:2.16.840.1.113883.4.642.40.2.42.23 |
The DEQM Gaps In Care DetectedIssue Profile indicates that the measure reported has an open gap or a closed gap as identified in the gapStatus modifier extension.
The following data-elements are mandatory (i.e data MUST be present).
Each DetectedIssue Must Have:
This profile builds on DetectedIssue.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
Name | Flags | Card. | Type | Description & Constraints![]() |
---|---|---|---|---|
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0..* | DetectedIssue | Clinical issue with action dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management | |
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?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children |
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?! | 1..* | Extension | Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
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?!S | 1..1 | DEQMGapStatusModifierExtension | Gap Status ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
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?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue. ele-1: All FHIR elements must have a @value or children |
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SΣ | 1..1 | CodeableConcept | Issue Category, e.g. drug-drug, duplicate therapy, etc. Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following |
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1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
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1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode | |
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1..1 | code | Symbol in syntax defined by the system Fixed Value: CAREGAP | |
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SΣ | 1..1 | Reference(QICore Patient) | Associated patient ele-1: All FHIR elements must have a @value or children |
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S | 1..* | BackboneElement | Supporting evidence ele-1: All FHIR elements must have a @value or children |
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
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S | 1..1 | Reference(DEQM Individual MeasureReport Profile | Detailed Care Gap Guidance Response) | This references either a DEQM Individual MeasureReport or a GuidanceResponse resource. Note that referencing the GuidanceResponse resource allows potential profiling on GuidanceResponse in the future without breaking backward compatibility. ele-1: All FHIR elements must have a @value or children |
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Path | Conformance | ValueSet / Code | URI |
DetectedIssue.status | required | ObservationStatushttp://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard | |
DetectedIssue.code | preferred | Pattern: CAREGAPhttp://hl7.org/fhir/ValueSet/detectedissue-category from the FHIR Standard |
This structure is derived from DetectedIssue
Name | Flags | Card. | Type | Description & Constraints![]() |
---|---|---|---|---|
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0..* | DetectedIssue | Clinical issue with action | |
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Content/Rules for all slices | |||
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?!S | 1..1 | DEQMGapStatusModifierExtension | Gap Status |
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S | 1..1 | CodeableConcept | Issue Category, e.g. drug-drug, duplicate therapy, etc. Required Pattern: At least the following |
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1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
![]() ![]() ![]() ![]() ![]() |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode | |
![]() ![]() ![]() ![]() ![]() |
1..1 | code | Symbol in syntax defined by the system Fixed Value: CAREGAP | |
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S | 1..1 | Reference(QICore Patient) | Associated patient |
![]() ![]() ![]() |
S | 1..* | BackboneElement | Supporting evidence |
![]() ![]() ![]() ![]() |
S | 1..1 | Reference(DEQM Individual MeasureReport Profile | Detailed Care Gap Guidance Response) | This references either a DEQM Individual MeasureReport or a GuidanceResponse resource. Note that referencing the GuidanceResponse resource allows potential profiling on GuidanceResponse in the future without breaking backward compatibility. |
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Name | Flags | Card. | Type | Description & Constraints![]() | ||||
---|---|---|---|---|---|---|---|---|
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0..* | DetectedIssue | Clinical issue with action | |||||
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Σ | 0..1 | id | Logical id of this artifact | ||||
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Σ | 0..1 | Meta | Metadata about the resource | ||||
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?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
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0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
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0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
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0..* | Resource | Contained, inline Resources | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?! | 1..* | Extension | Extension Slice: Unordered, Open by value:url | ||||
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?!S | 1..1 | DEQMGapStatusModifierExtension | Gap Status | ||||
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Σ | 0..* | Identifier | Unique id for the detected issue | ||||
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?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue. | ||||
![]() ![]() ![]() |
SΣ | 1..1 | CodeableConcept | Issue Category, e.g. drug-drug, duplicate therapy, etc. Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc. Required Pattern: At least the following | ||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
![]() ![]() ![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
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1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode | |||||
![]() ![]() ![]() ![]() ![]() |
0..1 | string | Version of the system - if relevant | |||||
![]() ![]() ![]() ![]() ![]() |
1..1 | code | Symbol in syntax defined by the system Fixed Value: CAREGAP | |||||
![]() ![]() ![]() ![]() ![]() |
0..1 | string | Representation defined by the system | |||||
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0..1 | boolean | If this coding was chosen directly by the user | |||||
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0..1 | string | Plain text representation of the concept | |||||
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Σ | 0..1 | code | high | moderate | low Binding: DetectedIssueSeverity (required): Indicates the potential degree of impact of the identified issue on the patient. | ||||
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SΣ | 1..1 | Reference(QICore Patient) | Associated patient | ||||
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Σ | 0..1 | When identified | |||||
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dateTime | |||||||
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Period | |||||||
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Σ | 0..1 | Reference(Practitioner | PractitionerRole | Device) | The provider or device that identified the issue | ||||
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Σ | 0..* | Reference(Resource) | Problem resource | ||||
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S | 1..* | BackboneElement | Supporting evidence | ||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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0..* | CodeableConcept | Manifestation Binding: ManifestationAndSymptomCodes (example): Codes that describes the types of evidence for a detected issue. | |||||
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S | 1..1 | Reference(DEQM Individual MeasureReport Profile | Detailed Care Gap Guidance Response) | This references either a DEQM Individual MeasureReport or a GuidanceResponse resource. Note that referencing the GuidanceResponse resource allows potential profiling on GuidanceResponse in the future without breaking backward compatibility. | ||||
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0..1 | string | Description and context | |||||
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0..1 | uri | Authority for issue | |||||
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0..* | BackboneElement | Step taken to address | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | CodeableConcept | What mitigation? Binding: DetectedIssueMitigationAction (preferred): Codes describing steps taken to resolve the issue or other circumstances that mitigate the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy documented', etc. | |||||
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0..1 | dateTime | Date committed | |||||
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0..1 | Reference(Practitioner | PractitionerRole) | Who is committing? | |||||
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Path | Conformance | ValueSet / Code | URI | |||
DetectedIssue.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languages from the FHIR Standard
| ||||
DetectedIssue.status | required | ObservationStatushttp://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard | ||||
DetectedIssue.code | preferred | Pattern: CAREGAPhttp://hl7.org/fhir/ValueSet/detectedissue-category from the FHIR Standard | ||||
DetectedIssue.severity | required | DetectedIssueSeverityhttp://hl7.org/fhir/ValueSet/detectedissue-severity|4.0.1 from the FHIR Standard | ||||
DetectedIssue.evidence.code | example | ManifestationAndSymptomCodeshttp://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard | ||||
DetectedIssue.mitigation.action | preferred | DetectedIssueMitigationActionhttp://hl7.org/fhir/ValueSet/detectedissue-mitigation-action from the FHIR Standard |
This structure is derived from DetectedIssue
Summary
Mandatory: 5 elements
Must-Support: 5 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Key Elements View
Name | Flags | Card. | Type | Description & Constraints![]() |
---|---|---|---|---|
![]() ![]() |
0..* | DetectedIssue | Clinical issue with action dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management | |
![]() ![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children |
![]() ![]() ![]() |
?! | 1..* | Extension | Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
![]() ![]() ![]() ![]() |
?!S | 1..1 | DEQMGapStatusModifierExtension | Gap Status ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
![]() ![]() ![]() |
?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue. ele-1: All FHIR elements must have a @value or children |
![]() ![]() ![]() |
SΣ | 1..1 | CodeableConcept | Issue Category, e.g. drug-drug, duplicate therapy, etc. Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following |
![]() ![]() ![]() ![]() |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
![]() ![]() ![]() ![]() ![]() |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode | |
![]() ![]() ![]() ![]() ![]() |
1..1 | code | Symbol in syntax defined by the system Fixed Value: CAREGAP | |
![]() ![]() ![]() |
SΣ | 1..1 | Reference(QICore Patient) | Associated patient ele-1: All FHIR elements must have a @value or children |
![]() ![]() ![]() |
S | 1..* | BackboneElement | Supporting evidence ele-1: All FHIR elements must have a @value or children |
![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
![]() ![]() ![]() ![]() |
S | 1..1 | Reference(DEQM Individual MeasureReport Profile | Detailed Care Gap Guidance Response) | This references either a DEQM Individual MeasureReport or a GuidanceResponse resource. Note that referencing the GuidanceResponse resource allows potential profiling on GuidanceResponse in the future without breaking backward compatibility. ele-1: All FHIR elements must have a @value or children |
![]() |
Path | Conformance | ValueSet / Code | URI |
DetectedIssue.status | required | ObservationStatushttp://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard | |
DetectedIssue.code | preferred | Pattern: CAREGAPhttp://hl7.org/fhir/ValueSet/detectedissue-category from the FHIR Standard |
Differential View
This structure is derived from DetectedIssue
Name | Flags | Card. | Type | Description & Constraints![]() |
---|---|---|---|---|
![]() ![]() |
0..* | DetectedIssue | Clinical issue with action | |
![]() ![]() ![]() |
Content/Rules for all slices | |||
![]() ![]() ![]() ![]() |
?!S | 1..1 | DEQMGapStatusModifierExtension | Gap Status |
![]() ![]() ![]() |
S | 1..1 | CodeableConcept | Issue Category, e.g. drug-drug, duplicate therapy, etc. Required Pattern: At least the following |
![]() ![]() ![]() ![]() |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
![]() ![]() ![]() ![]() ![]() |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode | |
![]() ![]() ![]() ![]() ![]() |
1..1 | code | Symbol in syntax defined by the system Fixed Value: CAREGAP | |
![]() ![]() ![]() |
S | 1..1 | Reference(QICore Patient) | Associated patient |
![]() ![]() ![]() |
S | 1..* | BackboneElement | Supporting evidence |
![]() ![]() ![]() ![]() |
S | 1..1 | Reference(DEQM Individual MeasureReport Profile | Detailed Care Gap Guidance Response) | This references either a DEQM Individual MeasureReport or a GuidanceResponse resource. Note that referencing the GuidanceResponse resource allows potential profiling on GuidanceResponse in the future without breaking backward compatibility. |
![]() |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints![]() | ||||
---|---|---|---|---|---|---|---|---|
![]() ![]() |
0..* | DetectedIssue | Clinical issue with action | |||||
![]() ![]() ![]() |
Σ | 0..1 | id | Logical id of this artifact | ||||
![]() ![]() ![]() |
Σ | 0..1 | Meta | Metadata about the resource | ||||
![]() ![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
![]() ![]() ![]() |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
![]() ![]() ![]() |
0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
![]() ![]() ![]() |
0..* | Resource | Contained, inline Resources | |||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() |
?! | 1..* | Extension | Extension Slice: Unordered, Open by value:url | ||||
![]() ![]() ![]() ![]() |
?!S | 1..1 | DEQMGapStatusModifierExtension | Gap Status | ||||
![]() ![]() ![]() |
Σ | 0..* | Identifier | Unique id for the detected issue | ||||
![]() ![]() ![]() |
?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue. | ||||
![]() ![]() ![]() |
SΣ | 1..1 | CodeableConcept | Issue Category, e.g. drug-drug, duplicate therapy, etc. Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc. Required Pattern: At least the following | ||||
![]() ![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
![]() ![]() ![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode | |||||
![]() ![]() ![]() ![]() ![]() |
0..1 | string | Version of the system - if relevant | |||||
![]() ![]() ![]() ![]() ![]() |
1..1 | code | Symbol in syntax defined by the system Fixed Value: CAREGAP | |||||
![]() ![]() ![]() ![]() ![]() |
0..1 | string | Representation defined by the system | |||||
![]() ![]() ![]() ![]() ![]() |
0..1 | boolean | If this coding was chosen directly by the user | |||||
![]() ![]() ![]() ![]() |
0..1 | string | Plain text representation of the concept | |||||
![]() ![]() ![]() |
Σ | 0..1 | code | high | moderate | low Binding: DetectedIssueSeverity (required): Indicates the potential degree of impact of the identified issue on the patient. | ||||
![]() ![]() ![]() |
SΣ | 1..1 | Reference(QICore Patient) | Associated patient | ||||
![]() ![]() ![]() |
Σ | 0..1 | When identified | |||||
![]() ![]() ![]() ![]() |
dateTime | |||||||
![]() ![]() ![]() ![]() |
Period | |||||||
![]() ![]() ![]() |
Σ | 0..1 | Reference(Practitioner | PractitionerRole | Device) | The provider or device that identified the issue | ||||
![]() ![]() ![]() |
Σ | 0..* | Reference(Resource) | Problem resource | ||||
![]() ![]() ![]() |
S | 1..* | BackboneElement | Supporting evidence | ||||
![]() ![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() |
0..* | CodeableConcept | Manifestation Binding: ManifestationAndSymptomCodes (example): Codes that describes the types of evidence for a detected issue. | |||||
![]() ![]() ![]() ![]() |
S | 1..1 | Reference(DEQM Individual MeasureReport Profile | Detailed Care Gap Guidance Response) | This references either a DEQM Individual MeasureReport or a GuidanceResponse resource. Note that referencing the GuidanceResponse resource allows potential profiling on GuidanceResponse in the future without breaking backward compatibility. | ||||
![]() ![]() ![]() |
0..1 | string | Description and context | |||||
![]() ![]() ![]() |
0..1 | uri | Authority for issue | |||||
![]() ![]() ![]() |
0..* | BackboneElement | Step taken to address | |||||
![]() ![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() |
1..1 | CodeableConcept | What mitigation? Binding: DetectedIssueMitigationAction (preferred): Codes describing steps taken to resolve the issue or other circumstances that mitigate the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy documented', etc. | |||||
![]() ![]() ![]() ![]() |
0..1 | dateTime | Date committed | |||||
![]() ![]() ![]() ![]() |
0..1 | Reference(Practitioner | PractitionerRole) | Who is committing? | |||||
![]() |
Path | Conformance | ValueSet / Code | URI | |||
DetectedIssue.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languages from the FHIR Standard
| ||||
DetectedIssue.status | required | ObservationStatushttp://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard | ||||
DetectedIssue.code | preferred | Pattern: CAREGAPhttp://hl7.org/fhir/ValueSet/detectedissue-category from the FHIR Standard | ||||
DetectedIssue.severity | required | DetectedIssueSeverityhttp://hl7.org/fhir/ValueSet/detectedissue-severity|4.0.1 from the FHIR Standard | ||||
DetectedIssue.evidence.code | example | ManifestationAndSymptomCodeshttp://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard | ||||
DetectedIssue.mitigation.action | preferred | DetectedIssueMitigationActionhttp://hl7.org/fhir/ValueSet/detectedissue-mitigation-action from the FHIR Standard |
This structure is derived from DetectedIssue
Summary
Mandatory: 5 elements
Must-Support: 5 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Other representations of profile: CSV, Excel, Schematron