Data Exchange For Quality Measures Implementation Guide
1.0.0-cibuild - CI Build International flag

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 1.0.0-cibuild 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

: Care Gaps Operation

Page standards status: Trial-use Maturity Level: 4

Raw json | Download

{
  "resourceType" : "OperationDefinition",
  "id" : "care-gaps",
  "language" : "en",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: OperationDefinition care-gaps</b></p><a name=\"care-gaps\"> </a><a name=\"hccare-gaps\"> </a><p>URL: [base]/Measure/$care-gaps</p><h3>Parameters</h3><table class=\"grid\"><tr><td><b>Use</b></td><td><b>Name</b></td><td><b>Scope</b></td><td><b>Cardinality</b></td><td><b>Type</b></td><td><b>Binding</b></td><td><b>Documentation</b></td></tr><tr><td>IN</td><td>measureUrl</td><td/><td>1..*</td><td><a href=\"http://hl7.org/fhir/R4/datatypes.html#canonical\">canonical</a></td><td/><td><div><p>The URL of a measure for which the gaps in care report will be created. A measure URL is specified in the <a href=\"https://www.hl7.org/fhir/measure-definitions.html#Measure.url\">url</a> element of the Measure resource. The measure URL remains the same when the measure is stored on different servers.</p>\n</div></td></tr><tr><td>IN</td><td>periodStart</td><td/><td>1..1</td><td><a href=\"http://hl7.org/fhir/R4/datatypes.html#date\">date</a></td><td/><td><div><p>The start of a <a href=\"glossary.html\">gaps through period</a>. 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.</p>\n</div></td></tr><tr><td>IN</td><td>periodEnd</td><td/><td>1..1</td><td><a href=\"http://hl7.org/fhir/R4/datatypes.html#date\">date</a></td><td/><td><div><p>The end of a <a href=\"glossary.html\">gaps through period</a> (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.</p>\n</div></td></tr><tr><td>IN</td><td>subject</td><td/><td>0..1</td><td><a href=\"http://hl7.org/fhir/R4/datatypes.html#string\">string</a><br/>(<a href=\"https://hl7.org/fhir/R4/search.html#reference\">reference</a>)</td><td/><td><div><p>Subject(s) for which the care gaps report will be produced. The subject may be             a Patient, Practitioner, PractitionerRole, Organization, Location, Device, or Group.             Subjects provided in this parameter SHALL match the subjectType of the measure             being evaluated (e.g. if the Measure.group.subjectType is Patient, the subject             SHALL be a reference to a Patient or a Group of Patients). If no subject is provided,             what subjects are evaluated is up to the server. This parameter cannot be used             with the subjectGroup parameter.</p>\n</div></td></tr><tr><td>IN</td><td>subjectGroup</td><td/><td>0..1</td><td><a href=\"http://hl7.org/fhir/R4/group.html\">Group</a></td><td/><td><div><p>Subject for which the gaps in care report will be created is provided as a Group resource. Subjects provided in this parameter SHALL match the subjectType of the measure being evaluated. (e.g. if the Measure.group.subjectType is Patient, the subject SHALL be a reference to a Patient or a Group of Patients). If no subject is provided, what subjects are evaluated is up to the server. This parameter cannot be used with the subject parameter.</p>\n</div></td></tr><tr><td>IN</td><td>reporter</td><td/><td>0..1</td><td><a href=\"http://hl7.org/fhir/R4/datatypes.html#string\">string</a><br/>(<a href=\"https://hl7.org/fhir/R4/search.html#reference\">reference</a>)</td><td/><td><div><p>The provider for which the report will be run. This may be a reference to a Practitioner,             PractitionerRole, or Organization. If specified, systems MAY use this information             to determine subjects for which the measure will be calculated, but how subjects             are determined is implementation-specific. This parameter is reflected in the reporter             element of the resulting MeasureReport(s). This parameter cannot be used with the             reporterResource parameter.</p>\n</div></td></tr><tr><td>IN</td><td>reporterResource</td><td/><td>0..1</td><td><a href=\"http://hl7.org/fhir/R4/practitioner.html\">Practitioner</a> | <a href=\"http://hl7.org/fhir/R4/practitionerrole.html\">PractitionerRole</a> | <a href=\"http://hl7.org/fhir/R4/organization.html\">Organization</a></td><td/><td><div><p>The provider for which the report will be run, provided as a Practitioner,         PractitionerRole, or Organization resource.             This is intended to support the use case in which the organization information             is not on the server performing the evaluation, for example an <a href=\"guidance.html#ad-hoc-organizations-for-deqm-operations\">ad-hoc group of             practitioners</a> that             are part of a provider group. This parameter is reflected in the reporter element             of the resulting MeasureReport(s). This parameter cannot be used with the reporter             parameter.</p>\n</div></td></tr><tr><td>IN</td><td>practitioner</td><td/><td>0..1</td><td><a href=\"http://hl7.org/fhir/R4/datatypes.html#string\">string</a><br/>(<a href=\"https://hl7.org/fhir/R4/search.html#reference\">reference</a>)</td><td/><td><div><p>Reference to a <a href=\"practitioner.html\">Practitioner</a> 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.</p>\n</div></td></tr><tr><td>IN</td><td>location</td><td/><td>0..*</td><td><a href=\"http://hl7.org/fhir/R4/datatypes.html#string\">string</a><br/>(<a href=\"https://hl7.org/fhir/R4/search.html#reference\">reference</a>)</td><td/><td><div><p>The location(s) for which the gaps in care report will be run. This parameter is             reflected in the location element of the resulting MeasureReport(s).</p>\n</div></td></tr><tr><td>IN</td><td>status</td><td/><td>1..*</td><td><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td><a href=\"ValueSet-deqm-gaps-status.html\">DEQM Gaps In Care Gap Status Value Set</a> (Extensible)</td><td><div><p>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 (&gt; 9%)), gap means the patient is in the numerator.</p>\n</div></td></tr><tr><td>IN</td><td>parameters</td><td/><td>0..1</td><td><a href=\"http://hl7.org/fhir/R4/parameters.html\">Parameters</a></td><td/><td><div><p>Any input parameters for the evaluation. Parameters defined in this input will be made available by name to the CQL expression. Parameter types are mapped to CQL as specified in the <a href=\"https://hl7.org/fhir/uv/cql/\">Using CQL with FHIR</a> implementation guide. 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.</p>\n</div></td></tr><tr><td>IN</td><td>manifest</td><td/><td>0..1</td><td><a href=\"http://hl7.org/fhir/R4/datatypes.html#canonical\">canonical</a> (<a href=\"http://hl7.org/fhir/R4/library.html\" title=\"http://hl7.org/fhir/StructureDefinition/Library\">Library</a>)</td><td/><td><div><p>Specifies an asset-collection library that provides dependency version resolution             and expansion rules for the operation. See the version manifest discussion in the             [Canonical Resource Management Infrastructure IG](http://hl7.org/fhir/uv/crmi/version-manifes             t.html) 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.</p>\n</div></td></tr><tr><td>IN</td><td>isDocument</td><td/><td>0..1</td><td><a href=\"http://hl7.org/fhir/R4/datatypes.html#boolean\">boolean</a></td><td/><td><div><p>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.'</p>\n</div></td></tr><tr><td>OUT</td><td>return</td><td/><td>0..*</td><td><a href=\"http://hl7.org/fhir/R4/bundle.html\">Bundle</a></td><td/><td><div><p>The $care-gaps operation returns zero or more Bundles, one for each input             subject. The isDocument parameter controls whether the bundles are documents conforming to             the GapsInCareBundle profile, or collection Bundles including just the MeasureReport and             related resources. See the [guidance on Bundle structure](https://build.fhir.org/clinicalre             asoning-quality-reporting.html#bundles-organized-by-subject) for discussion about             the Bundle content and organization.\\n\\nNote 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 <a href=\"operations.html#response\">response</a>.</p>\n</div></td></tr></table><div><p>The effect of invoking this operation is to calculate a measure or a set of measures based on the In Parameters provided and to return Parameters resource containing one or more document bundles describing the gaps in care results         of each measure, for the specified gaps through period and for the given subject (a patient or a group of patients). Because more than one bundle may be returned, the operation parameter must always be returned.  Note that it is up to the Server to determine whether         or not the generated gaps in care report is persisted. If the Server does not persist the results, the operation does not affect state and can be invoked with a GET. Note that this operation is intended to replace the existing base Measure $care-gaps operation in FHIR R5.</p>\n</div></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "cqi"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger" : 4,
      "_valueInteger" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical" : "http://hl7.org/fhir/uv/deqm/ImplementationGuide/hl7.fhir.uv.deqm"
          }
        ]
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode" : "trial-use",
      "_valueCode" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical" : "http://hl7.org/fhir/uv/deqm/ImplementationGuide/hl7.fhir.uv.deqm"
          }
        ]
      }
    }
  ],
  "url" : "http://hl7.org/fhir/uv/deqm/OperationDefinition/care-gaps",
  "version" : "1.0.0-cibuild",
  "name" : "CareGaps",
  "title" : "Care Gaps Operation",
  "status" : "active",
  "kind" : "operation",
  "date" : "2021-04-23",
  "publisher" : "HL7 International / Clinical Quality Information",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/cqi"
        }
      ]
    }
  ],
  "description" : "The care-gaps operation is used to determine gaps in care for a specified [gaps through period](glossary.html) based on the results of quality measures.  It is often the case that the operation should not be performed from the server's timezone, rather the client's timezone is typically a more correct option. Note that even this isn't always correct because the evaluation may be running over data from multiple sources in different timezones. Providing guidance to the measure evaluator with the timezone header can facilitate consistent behavior.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code" : "001",
          "display" : "World"
        }
      ]
    }
  ],
  "code" : "care-gaps",
  "comment" : "The effect of invoking this operation is to calculate a measure or a set of measures based on the In Parameters provided and to return Parameters resource containing one or more document bundles describing the gaps in care results         of each measure, for the specified gaps through period and for the given subject (a patient or a group of patients). Because more than one bundle may be returned, the operation parameter must always be returned.  Note that it is up to the Server to determine whether         or not the generated gaps in care report is persisted. If the Server does not persist the results, the operation does not affect state and can be invoked with a GET. Note that this operation is intended to replace the existing base Measure $care-gaps operation in FHIR R5.",
  "base" : "http://hl7.org/fhir/OperationDefinition/Measure-care-gaps",
  "resource" : [
    "Measure"
  ],
  "system" : false,
  "type" : true,
  "instance" : false,
  "parameter" : [
    {
      "name" : "measureUrl",
      "use" : "in",
      "min" : 1,
      "max" : "*",
      "documentation" : "The URL of a measure for which the gaps in care report will be created. A measure URL is specified in the [url](https://www.hl7.org/fhir/measure-definitions.html#Measure.url) element of the Measure resource. The measure URL remains the same when the measure is stored on different servers.",
      "type" : "canonical"
    },
    {
      "name" : "periodStart",
      "use" : "in",
      "min" : 1,
      "max" : "1",
      "documentation" : "The start of a [gaps through period](glossary.html). 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.",
      "type" : "date"
    },
    {
      "name" : "periodEnd",
      "use" : "in",
      "min" : 1,
      "max" : "1",
      "documentation" : "The end of a [gaps through period](glossary.html) (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.",
      "type" : "date"
    },
    {
      "name" : "subject",
      "use" : "in",
      "min" : 0,
      "max" : "1",
      "documentation" : "Subject(s) for which the care gaps report will be produced. The subject may be             a Patient, Practitioner, PractitionerRole, Organization, Location, Device, or Group.             Subjects provided in this parameter SHALL match the subjectType of the measure             being evaluated (e.g. if the Measure.group.subjectType is Patient, the subject             SHALL be a reference to a Patient or a Group of Patients). If no subject is provided,             what subjects are evaluated is up to the server. This parameter cannot be used             with the subjectGroup parameter.",
      "type" : "string",
      "searchType" : "reference"
    },
    {
      "name" : "subjectGroup",
      "use" : "in",
      "min" : 0,
      "max" : "1",
      "documentation" : "Subject for which the gaps in care report will be created is provided as a Group resource. Subjects provided in this parameter SHALL match the subjectType of the measure being evaluated. (e.g. if the Measure.group.subjectType is Patient, the subject SHALL be a reference to a Patient or a Group of Patients). If no subject is provided, what subjects are evaluated is up to the server. This parameter cannot be used with the subject parameter.",
      "type" : "Group"
    },
    {
      "name" : "reporter",
      "use" : "in",
      "min" : 0,
      "max" : "1",
      "documentation" : "The provider for which the report will be run. This may be a reference to a Practitioner,             PractitionerRole, or Organization. If specified, systems MAY use this information             to determine subjects for which the measure will be calculated, but how subjects             are determined is implementation-specific. This parameter is reflected in the reporter             element of the resulting MeasureReport(s). This parameter cannot be used with the             reporterResource parameter.",
      "type" : "string",
      "searchType" : "reference"
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/operationdefinition-allowed-type",
          "valueUri" : "Practitioner"
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/operationdefinition-allowed-type",
          "valueUri" : "PractitionerRole"
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/operationdefinition-allowed-type",
          "valueUri" : "Organization"
        }
      ],
      "name" : "reporterResource",
      "use" : "in",
      "min" : 0,
      "max" : "1",
      "documentation" : "The provider for which the report will be run, provided as a Practitioner,         PractitionerRole, or Organization resource.             This is intended to support the use case in which the organization information             is not on the server performing the evaluation, for example an [ad-hoc group of             practitioners](guidance.html#ad-hoc-organizations-for-deqm-operations) that             are part of a provider group. This parameter is reflected in the reporter element             of the resulting MeasureReport(s). This parameter cannot be used with the reporter             parameter.",
      "type" : "DomainResource"
    },
    {
      "name" : "practitioner",
      "use" : "in",
      "min" : 0,
      "max" : "1",
      "documentation" : "Reference to a [Practitioner](practitioner.html) 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.",
      "type" : "string",
      "searchType" : "reference"
    },
    {
      "name" : "location",
      "use" : "in",
      "min" : 0,
      "max" : "*",
      "documentation" : "The location(s) for which the gaps in care report will be run. This parameter is             reflected in the location element of the resulting MeasureReport(s).",
      "type" : "string",
      "searchType" : "reference"
    },
    {
      "name" : "status",
      "use" : "in",
      "min" : 1,
      "max" : "*",
      "documentation" : "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.",
      "type" : "code",
      "binding" : {
        "strength" : "extensible",
        "valueSet" : "http://hl7.org/fhir/uv/deqm/ValueSet/deqm-gaps-status"
      }
    },
    {
      "name" : "parameters",
      "use" : "in",
      "min" : 0,
      "max" : "1",
      "documentation" : "Any input parameters for the evaluation. Parameters defined in this input will be made available by name to the CQL expression. Parameter types are mapped to CQL as specified in the [Using CQL with FHIR](https://hl7.org/fhir/uv/cql/) implementation guide. 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.",
      "type" : "Parameters"
    },
    {
      "name" : "manifest",
      "use" : "in",
      "min" : 0,
      "max" : "1",
      "documentation" : "Specifies an asset-collection library that provides dependency version resolution             and expansion rules for the operation. See the version manifest discussion in the             [Canonical Resource Management Infrastructure IG](http://hl7.org/fhir/uv/crmi/version-manifes             t.html) 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.",
      "type" : "canonical",
      "targetProfile" : [
        🔗 "http://hl7.org/fhir/StructureDefinition/Library"
      ]
    },
    {
      "name" : "isDocument",
      "use" : "in",
      "min" : 0,
      "max" : "1",
      "documentation" : "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.'",
      "type" : "boolean"
    },
    {
      "name" : "return",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "documentation" : "The $care-gaps operation returns zero or more Bundles, one for each input             subject. The isDocument parameter controls whether the bundles are documents conforming to             the GapsInCareBundle profile, or collection Bundles including just the MeasureReport and             related resources. See the [guidance on Bundle structure](https://build.fhir.org/clinicalre             asoning-quality-reporting.html#bundles-organized-by-subject) for discussion about             the Bundle content and organization.\\n\\nNote 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 [response](operations.html#response).",
      "type" : "Bundle"
    }
  ]
}