Da Vinci Risk Adjustment Implementation Guide
2.1.0 - STU 2.1

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

## : Submit Data example for sending a C-CDA document - XML Representation

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    <Parameters xmlns="http://hl7.org/fhir">
      <id value="ra-submit-data"/>
      <meta>
        <extension url="http://hl7.org/fhir/StructureDefinition/instance-name">
          <valueString value="Submit Data example for sending a C-CDA document"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/instance-description">
          <valueMarkdown
                         value="This is an example for using $submit-data oepration to send a C-CDA document as supporting evidence using the RA Data Exchange MeasureReport."/>
        </extension>
      </meta>
      <parameter>
        <name value="MeasureReport"/>
        <resource>
          <MeasureReport>
            <id value="ra-datax-measurereport01"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-datax-measurereport"/>
            </meta>
            <text>
              <status value="extensions"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: MeasureReport</b><a name="ra-datax-measurereport01"> </a></p><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">Resource MeasureReport &quot;ra-datax-measurereport01&quot; </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-ra-datax-measurereport.html">Risk Adjustment Data Exchange MeasureReport</a></p></div><p><b>Payer Coding Gap Report Id</b>: ra-measurereport01</p><p><b>status</b>: complete</p><p><b>type</b>: data-collection</p><p><b>measure</b>: <a href="Measure-RAModelExample01.html">Risk Adjustment Model Version 24 - CMS Hierarchical Category Condition (CMS-HCC)</a></p><p><b>subject</b>: <a href="Patient-ra-patient01.html">Patient/ra-patient01</a> &quot; EVERYWOMAN&quot;</p><p><b>date</b>: 2021-11-10</p><p><b>reporter</b>: <a href="Organization-ra-org02pat02.html">Organization/ra-org02pat02</a> &quot;GHH Outpatient Clinic&quot;</p><p><b>period</b>: 2021-01-01 --&gt; 2021-09-30</p><p><b>evaluatedResource</b>: <a href="DocumentReference-ra-documentreference01pat01.html">DocumentReference/ra-documentreference01pat01</a></p></div>
            </text>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/measurereport-category">
              <valueCodeableConcept>
                <coding>
                  <system
                          value="http://hl7.org/fhir/CodeSystem/measurereport-category"/>
                  <code value="ra"/>
                </coding>
              </valueCodeableConcept>
            </extension>
            <extension
                       url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-payerCodingGapReportId">
              <valueId value="ra-measurereport01"/>
            </extension>
            <status value="complete"/>
            <type value="data-collection"/>
            <measure
                     value="http://hl7.org/fhir/us/davinci-ra/Measure/RAModelExample01"/>
            <subject>🔗
              <reference value="Patient/ra-patient01"/>
            </subject>
            <date value="2021-11-10"/>
            <reporter>🔗
              <reference value="Organization/ra-org02pat02"/>
            </reporter>
            <period>
              <start value="2021-01-01"/>
              <end value="2021-09-30"/>
            </period>
            <evaluatedResource>🔗
              <reference value="DocumentReference/ra-documentreference01pat01"/>
            </evaluatedResource>
          </MeasureReport>
        </resource>
      </parameter>
      <parameter>
        <name value="resource"/>
        <resource>
          <DocumentReference>
            <id value="ra-documentreference01pat01"/>
            <meta>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/instance-name">
                <valueString value="Episode Summary Example"/>
              </extension>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/instance-description">
                <valueMarkdown
                               value="This is a episode summary example for the *US Core DocumentReference Profile*."/>
              </extension>
              <profile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference|7.0.0"/>
            </meta>
            <text>
              <status value="extensions"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: DocumentReference ra-documentreference01pat01</b></p><a name="ra-documentreference01pat01"> </a><a name="hcra-documentreference01pat01"> </a><a name="ra-documentreference01pat01-en-US"> </a><p><b>identifier</b>: <a href="http://terminology.hl7.org/5.5.0/NamingSystem-uri.html" title="As defined by RFC 3986 (http://www.ietf.org/rfc/rfc3986.txt)(with many schemes defined in many RFCs). For OIDs and UUIDs, use the URN form (urn:oid:(note: lowercase) and urn:uuid:). See http://www.ietf.org/rfc/rfc3001.txt and http://www.ietf.org/rfc/rfc4122.txt

    This oid is used as an identifier II.root to indicate the the extension is an absolute URI (technically, an IRI). Typically, this is used for OIDs and GUIDs. Note that when this OID is used with OIDs and GUIDs, the II.extension should start with urn:oid or urn:uuid:

    Note that this OID is created to aid with interconversion between CDA and FHIR - FHIR uses urn:ietf:rfc:3986 as equivalent to this OID. URIs as identifiers appear more commonly in FHIR.

    This OID may also be used in CD.codeSystem.">Uniform Resource Identifier (URI)</a>/urn:oid:2.16.840.1.113883.19.5.99999.1</p><p><b>status</b>: Current</p><p><b>type</b>: <span title="Codes:{http://loinc.org 34108-1}">CCD Document</span></p><p><b>category</b>: <span title="Codes:{http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category clinical-note}">Clinical Note</span></p><p><b>subject</b>: <a href="Patient-ra-patient01.html">Eve Everywoman</a></p><p><b>date</b>: 2021-03-27 15:29:46+0000</p><p><b>author</b>: <a href="Practitioner-ra-prac01pat01.html">Harold Hippocrates, MD</a></p><p><b>description</b>: Clinical Note</p><blockquote><p><b>content</b></p><h3>Attachments</h3><table class="grid"><tr><td style="display: none">-</td><td><b>ContentType</b></td><td><b>Data</b></td></tr><tr><td style="display: none">*</td><td>text/plain</td><td><code>DQpQYXRpZW50OiBFdmUgRXZlcnl3b21lbg0KRE9COiAgMS8xNi8xOTc1DQpNUiM6ICAxMjM0NQ0KDQpEYXRlIG9mIFZpc2l0OiAzLzI3LzIwMjENClBhdGllbnQgcmVwb3J0cyB0aGUgaW5hYmlsaXR5IHRvIGRpZ2VzdCBmb29kIHByb3Blcmx5IGR1ZSB0byBhbiBpbnN1ZmZpY2llbmN5IGluIGV4b2NyaW5lIHBhbmNyZWF0aWMgZGlnZXN0aXZlIGVuenltZXMuIFBhdGllbnQgZXhwZXJpZW5jaW5nIGFiZG9taW5hbCBwYWluLCBkaWFycmhlYSwgZ2FzLCBhbmQgd2VpZ2h0IGxvc3MuIE9yZGVyZWQgUEVSVCB0cmVhdG1lbnQuDQoNCg0KDQpIYXJvbGQgSGlwcG9jcmF0ZXMsIE1EDQo=</code></td></tr></table></blockquote></div>
            </text>
            <identifier>
              <system value="urn:ietf:rfc:3986"/>
              <value value="urn:oid:2.16.840.1.113883.19.5.99999.1"/>
            </identifier>
            <status value="current"/>
            <type>
              <coding>
                <system value="http://loinc.org"/>
                <code value="34108-1"/>
                <display value="Outpatient Note"/>
              </coding>
              <text value="CCD Document"/>
            </type>
            <category>
              <coding>
                <system
                        value="http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category"/>
                <code value="clinical-note"/>
                <display value="Clinical Note"/>
              </coding>
              <text value="Clinical Note"/>
            </category>
            <subject>🔗
              <reference value="Patient/ra-patient01"/>
              <display value="Eve Everywoman"/>
            </subject>
            <date value="2021-03-27T15:29:46Z"/>
            <author>🔗
              <reference value="Practitioner/ra-prac01pat01"/>
              <display value="Harold Hippocrates, MD"/>
            </author>
            <description value="Clinical Note"/>
            <content>
              <attachment>
                <contentType value="text/plain"/>
                <data
                      value="DQpQYXRpZW50OiBFdmUgRXZlcnl3b21lbg0KRE9COiAgMS8xNi8xOTc1DQpNUiM6ICAxMjM0NQ0KDQpEYXRlIG9mIFZpc2l0OiAzLzI3LzIwMjENClBhdGllbnQgcmVwb3J0cyB0aGUgaW5hYmlsaXR5IHRvIGRpZ2VzdCBmb29kIHByb3Blcmx5IGR1ZSB0byBhbiBpbnN1ZmZpY2llbmN5IGluIGV4b2NyaW5lIHBhbmNyZWF0aWMgZGlnZXN0aXZlIGVuenltZXMuIFBhdGllbnQgZXhwZXJpZW5jaW5nIGFiZG9taW5hbCBwYWluLCBkaWFycmhlYSwgZ2FzLCBhbmQgd2VpZ2h0IGxvc3MuIE9yZGVyZWQgUEVSVCB0cmVhdG1lbnQuDQoNCg0KDQpIYXJvbGQgSGlwcG9jcmF0ZXMsIE1EDQo="/>
              </attachment>
            </content>
          </DocumentReference>
        </resource>
      </parameter>
      <parameter>
        <name value="resource"/>
        <resource>
          <Patient>
            <id value="ra-patient01"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|7.0.0"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;"><b>Eve Everywoman (OFFICIAL)</b> female, DoB: 1975-01-16 ( Medical record number/12345 (use: USUAL))</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Record is active">Active:</td><td>true</td><td style="background-color: #f3f5da" title="Known status of Patient">Deceased:</td><td>false</td></tr><tr><td style="background-color: #f3f5da" title="Known Marital status of Patient">Marital Status:</td><td colspan="3"><span title="Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}">Married</span></td></tr><tr><td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Detail:</td><td colspan="3">2222 Home Street Ann Arbor MI 99999 USA (HOME)</td></tr><tr><td style="background-color: #f3f5da" title="Languages spoken">Language:</td><td colspan="3"><span title="Codes: {urn:ietf:bcp:47 en-US}">English (United States)</span> (preferred)</td></tr><tr><td style="background-color: #f3f5da" title="Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.">US Core Ethnicity Extension:</td><td colspan="3"><ul><li>ombCategory: <a href="http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-cdcrec.html#cdcrec-2186-5">Race &amp; Ethnicity - CDC</a> 2186-5: Not Hispanic or Latino</li><li>text: Not Hispanic or Latino</li></ul></td></tr><tr><td style="background-color: #f3f5da" title="A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc). This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9)."><a href="http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-birthsex.html">US Core Birth Sex Extension:</a></td><td colspan="3"><ul><li>F</li></ul></td></tr><tr><td style="background-color: #f3f5da" title="Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:

     - American Indian or Alaska Native
     - Asian
     - Black or African American
     - Native Hawaiian or Other Pacific Islander
     - White.">US Core Race Extension:</td><td colspan="3"><ul><li>ombCategory: <a href="http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-cdcrec.html#cdcrec-2106-3">Race &amp; Ethnicity - CDC</a> 2106-3: White</li><li>text: White</li></ul></td></tr></table></div>
            </text>
            <extension
                       url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex">
              <valueCode value="F"/>
            </extension>
            <extension
                       url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">
              <extension url="ombCategory">
                <valueCoding>
                  <system value="urn:oid:2.16.840.1.113883.6.238"/>
                  <code value="2106-3"/>
                  <display value="White"/>
                </valueCoding>
              </extension>
              <extension url="text">
                <valueString value="White"/>
              </extension>
            </extension>
            <extension
                       url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity">
              <extension url="ombCategory">
                <valueCoding>
                  <system value="urn:oid:2.16.840.1.113883.6.238"/>
                  <code value="2186-5"/>
                  <display value="Not Hispanic or Latino"/>
                </valueCoding>
              </extension>
              <extension url="text">
                <valueString value="Not Hispanic or Latino"/>
              </extension>
            </extension>
            <identifier>
              <use value="usual"/>
              <type>
                <coding>
                  <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
                  <code value="MR"/>
                  <display value="Medical record number"/>
                </coding>
              </type>
              <system value="http://example.org/hospital-davinci"/>
              <value value="12345"/>
            </identifier>
            <active value="true"/>
            <name>
              <use value="official"/>
              <family value="Everywoman"/>
              <given value="Eve"/>
            </name>
            <gender value="female"/>
            <birthDate value="1975-01-16"/>
            <deceasedBoolean value="false"/>
            <address>
              <use value="home"/>
              <line value="2222 Home Street"/>
              <city value="Ann Arbor"/>
              <state value="MI"/>
              <postalCode value="99999"/>
              <country value="USA"/>
            </address>
            <maritalStatus>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/v3-MaritalStatus"/>
                <code value="M"/>
                <display value="Married"/>
              </coding>
            </maritalStatus>
            <communication>
              <language>
                <coding>
                  <system value="urn:ietf:bcp:47"/>
                  <code value="en-US"/>
                  <display value="English (United States)"/>
                </coding>
              </language>
              <preferred value="true"/>
            </communication>
          </Patient>
        </resource>
      </parameter>
    </Parameters>