Da Vinci Risk Adjustment Implementation Guide
2.1.0 - STU 2.1 United States of America flag

Da Vinci Risk Adjustment Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-ra/ and changes regularly. See the Directory of published versions

: Risk Gap - XML Representation

Page standards status: Draft Maturity Level: 1

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<OperationDefinition xmlns="http://hl7.org/fhir">
  <id value="risk-gap"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: OperationDefinition risk-gap</b></p><a name="risk-gap"> </a><a name="hcrisk-gap"> </a><p>URL: [base]/MeasureReport/$risk-gap</p><p>URL: [base]/MeasureReport/[id]/$risk-gap</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>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 clinical evaluation period.</p>
</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 clinical evaluation period.</p>
</div></td></tr><tr><td>IN</td><td>subject</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/patient.html">Patient</a> (<a href="http://hl7.org/fhir/us/core/STU7/StructureDefinition-us-core-patient.html" title="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|7.0.0">US Core Patient Profile</a>)</td><td/><td><div><p>Patient resource as input parameter, which provides data such as patient's first name, last name, date of birth</p>
</div></td></tr><tr><td>IN</td><td>coverage</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/coverage.html">Coverage</a> (<a href="http://hl7.org/fhir/us/core/STU7/StructureDefinition-us-core-coverage.html" title="http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage|7.0.0">US Core Coverage Profile</a>)</td><td/><td><div><p>This is a reference to the Coverage resource, which provides information such as the subscriberId</p>
</div></td></tr><tr><td>IN</td><td>TIN</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#token">token</a>)</td><td/><td><div><p>This is the provider rganization's TIN</p>
</div></td></tr><tr><td>IN</td><td>ccType</td><td/><td>0..*</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#code">code</a></td><td><a href="ValueSet-cc-type.html">Condition Category Type</a> (Extensible)</td><td><div><p>This Condition Category (CC) gaps will be filterd based on the CC type code, whether it is suspected, historic, and/or net-new.</p>
</div></td></tr><tr><td>IN</td><td>evidenceStatus</td><td/><td>0..*</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#code">code</a></td><td><a href="ValueSet-evidence-status.html">Evidence Status</a> (Extensible)</td><td><div><p>This Condition Category (CC) gaps will be filterd based on the evidence status, whether the gap is an open-gap, invalid-gap, closed-gap, and/or pending.</p>
</div></td></tr><tr><td>IN</td><td>providerTaxonomy</td><td/><td>0..*</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#code">code</a></td><td><a href="http://hl7.org/fhir/R4/valueset-provider-taxonomy.html">ProviderTaxonomy</a> (Extensible)</td><td><div><p>This Condition Category (CC) gaps will be filterd based on provider taxonomy.</p>
</div></td></tr><tr><td>IN</td><td>encounter</td><td/><td>0..1</td><td><a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a> (<a href="http://hl7.org/fhir/us/core/STU7/StructureDefinition-us-core-encounter.html" title="http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter|7.0.0">US Core Encounter Profile</a>)</td><td/><td><div><p>This is a reference to the Encounter resource, which provides information such as the encounter id and date of service.</p>
</div></td></tr><tr><td>IN</td><td>contextId</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#token">token</a>)</td><td/><td><div><p>The contextId is intended to be used for 'non-standard' identifiers, for example, some systems may have an internally defined gap-request-id</p>
</div></td></tr><tr><td>IN</td><td>referenced</td><td/><td>0..*</td><td><a href="http://hl7.org/fhir/R4/resource.html">Resource</a></td><td/><td><div><p>Any resources that are referenced by other input parameters defined in this operation. For example, Coverage.payor that is an Organization resource referenced by Coverage , which can then be included here using this parameter 'referenced'</p>
</div></td></tr><tr><td>OUT</td><td>return</td><td/><td>0..1</td><td><a href="http://hl7.org/fhir/R4/bundle.html">Bundle</a></td><td/><td><div><p>This operation returns a Bundle of MeasureReports and associated resources</p>
</div></td></tr></table></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="1"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="cqi"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="draft"/>
  </extension>
  <url
       value="http://hl7.org/fhir/us/davinci-ra/OperationDefinition/risk-gap"/>
  <version value="2.1.0"/>
  <name value="RiskGap"/>
  <title value="Risk Gap"/>
  <status value="draft"/>
  <kind value="operation"/>
  <date value="2025-09-16T04:39:23+00:00"/>
  <publisher value="HL7 International / Clinical Quality Information"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cqi"/>
    </telecom>
  </contact>
  <description
               value="The risk-gap operation is used to determine condition Category (CC) gaps for a patient/member."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <code value="risk-gap"/>
  <resource value="MeasureReport"/>
  <system value="false"/>
  <type value="true"/>
  <instance value="true"/>
  <parameter>
    <name value="periodStart"/>
    <use value="in"/>
    <min value="1"/>
    <max value="1"/>
    <documentation value="The start of a clinical evaluation period."/>
    <type value="date"/>
  </parameter>
  <parameter>
    <name value="periodEnd"/>
    <use value="in"/>
    <min value="1"/>
    <max value="1"/>
    <documentation value="The end of a clinical evaluation period."/>
    <type value="date"/>
  </parameter>
  <parameter>
    <name value="subject"/>
    <use value="in"/>
    <min value="1"/>
    <max value="1"/>
    <documentation
                   value="Patient resource as input parameter, which provides data such as patient's first name, last name, date of birth"/>
    <type value="Patient"/>
    <targetProfile
                   value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|7.0.0"/>
  </parameter>
  <parameter>
    <name value="coverage"/>
    <use value="in"/>
    <min value="1"/>
    <max value="1"/>
    <documentation
                   value="This is a reference to the Coverage resource, which provides information such as the subscriberId"/>
    <type value="Coverage"/>
    <targetProfile
                   value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage|7.0.0"/>
  </parameter>
  <parameter>
    <name value="TIN"/>
    <use value="in"/>
    <min value="0"/>
    <max value="1"/>
    <documentation value="This is the provider rganization's TIN"/>
    <type value="string"/>
    <searchType value="token"/>
  </parameter>
  <parameter>
    <name value="ccType"/>
    <use value="in"/>
    <min value="0"/>
    <max value="*"/>
    <documentation
                   value="This Condition Category (CC) gaps will be filterd based on the CC type code, whether it is suspected, historic, and/or net-new."/>
    <type value="code"/>
    <binding>
      <strength value="extensible"/>
      <valueSet value="http://hl7.org/fhir/us/davinci-ra/ValueSet/cc-type"/>
    </binding>
  </parameter>
  <parameter>
    <name value="evidenceStatus"/>
    <use value="in"/>
    <min value="0"/>
    <max value="*"/>
    <documentation
                   value="This Condition Category (CC) gaps will be filterd based on the evidence status, whether the gap is an open-gap, invalid-gap, closed-gap, and/or pending."/>
    <type value="code"/>
    <binding>
      <strength value="extensible"/>
      <valueSet
                value="http://hl7.org/fhir/us/davinci-ra/ValueSet/evidence-status"/>
    </binding>
  </parameter>
  <parameter>
    <name value="providerTaxonomy"/>
    <use value="in"/>
    <min value="0"/>
    <max value="*"/>
    <documentation
                   value="This Condition Category (CC) gaps will be filterd based on provider taxonomy."/>
    <type value="code"/>
    <binding>
      <strength value="extensible"/>
      <valueSet value="http://hl7.org/fhir/ValueSet/provider-taxonomy"/>
    </binding>
  </parameter>
  <parameter>
    <name value="encounter"/>
    <use value="in"/>
    <min value="0"/>
    <max value="1"/>
    <documentation
                   value="This is a reference to the Encounter resource, which provides information such as the encounter id and date of service."/>
    <type value="Encounter"/>
    <targetProfile
                   value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter|7.0.0"/>
  </parameter>
  <parameter>
    <name value="contextId"/>
    <use value="in"/>
    <min value="0"/>
    <max value="1"/>
    <documentation
                   value="The contextId is intended to be used for 'non-standard' identifiers, for example, some systems may have an internally defined gap-request-id"/>
    <type value="string"/>
    <searchType value="token"/>
  </parameter>
  <parameter>
    <name value="referenced"/>
    <use value="in"/>
    <min value="0"/>
    <max value="*"/>
    <documentation
                   value="Any resources that are referenced by other input parameters defined in this operation. For example, Coverage.payor that is an Organization resource referenced by Coverage , which can then be included here using this parameter 'referenced'"/>
    <type value="Resource"/>
  </parameter>
  <parameter>
    <name value="return"/>
    <use value="out"/>
    <min value="0"/>
    <max value="1"/>
    <documentation
                   value="This operation returns a Bundle of MeasureReports and associated resources"/>
    <type value="Bundle"/>
  </parameter>
</OperationDefinition>