QI-Core Implementation Guide
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QI-Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 7.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-qi-core/ and changes regularly. See the Directory of published versions

Resource Profile: QICore Communication Not Done

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communicationnotdone Version: 7.0.0
Active as of 2023-08-01 Computable Name: QICoreCommunicationNotDone

Negation profile of Communication for decision support/quality metrics. Indicates that the communication was not performed for a reason.

"Must Have", "QI Elements" and "primary code path" are defined in the QI-Core Must Support section.
QI Elements:
  • extension(event-recorded): (QI) Captures the recorded date of the communication
  • status: (QI) not-done
  • status: (QI) not-done
  • statusReason: (QI) Reason for current status
  • subject: (QI) Focus of message
  • topic: (QI) Description of the purpose/content
  • topic.extension(codeOptions): (QI) Url of a value set of candidate topics
  • sent: (QI) When sent
  • received: (QI) When received
  • recipient: (QI) Message recipient
  • sender: (QI) Message sender
Primary code path: reasonCode
(PCPath) This element is the primary code path for this resource CQL Retrieve


NOTE TO BALLOT REVIEWERS:
  • US Core 7.0, and thus QI-Core 7.0, has a new approach to USCDI requirements.
    • As noted in the US Core 7.0 Must Support section, US Core 7.0 no longer highlights mandatory (cardinality 1..* or 1..1) and Must Support elements with a (USCDI) indicator as such items must be supported for interoperability.
    • Those USCDI elements that are not mandatory or Must Support now include an indicator (ADDITIONAL USCDI) in US Core. QI-Core 7.0 does not reference USCDI elements; rather, users should access US Core 7.0 to understand its implementation of USCDI version 4.
  • We invite comments about the approach and suggestions for other options that would also avoid unnecessary noise or reading load to the QI-Core profile representation.
  • Further, QI-Core 7.0 does not discuss USCDI+Quality because at the time of ballot preparation, no published version of USCDI+Quality is available. We seek reviewer advice regarding how QI-Core might address future USCDI+Quality.

Usage

The Communication profile defines the conformance expectations for a Communication event, regardless of whether it is a positive or negative statement.

The CommunicationDone and CommunicationNotDone profiles represent the positive and negative statements for a communication event.

This example meets measure intent for exclusion as defined in the following example CQL:

define CommunicationNoteDone:
  [CommunicationNotDone: "Macular edema absent (finding)"] MacularEdemaAbsentNotCommunicated
    with "Diabetic Retinopathy Encounter" EncounterDiabeticRetinopathy
      such that MacularEdemaAbsentNotCommunicated.sent during EncounterDiabeticRetinopathy.period
        and ( MacularEdemaAbsentNotCommunicated.statusReason in "Medical Reason"
          or MacularEdemaAbsentNotCommunicated.statusReason in "Patient Reason"
        )

For a more complete discussion of representation of negation within QI-Core and quality improvement artifacts, see the Negation in QI-Core topic.

See the patterns page for implementation and usage patterns.

Examples

Negation Example using a single coded conceptCommunication of finding of Macular Edema absent not done because patient moved away.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication C 0..* QICoreCommunication A record of information transmitted from a sender to a receiver
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
com-1: to indicate what communication, either at least one coding in the topic or a codeOptions extension shall be provided
... implicitRules ?!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
... Slices for extension 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
.... event-recorded 1..1 dateTime (QI) Captures the recorded date of the communication
URL: http://hl7.org/fhir/StructureDefinition/event-recorded
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... statusReason Σ 1..1 CodeableConcept (QI) Reason for current status
Binding: QICore Negation Reason Codes (extensible)
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Communication.statusrequiredFixed Value: not-done
http://hl7.org/fhir/ValueSet/event-status|4.0.1
from the FHIR Standard
Communication.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
from this IG

Constraints

IdGradePath(s)DetailsRequirements
com-1errorCommunicationto indicate what communication, either at least one coding in the topic or a codeOptions extension shall be provided
: topic.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor (topic.coding.exists() or topic.text.exists())
dom-2errorCommunicationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCommunicationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorCommunicationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorCommunicationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCommunicationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

 

Other representations of profile: CSV, Excel, Schematron