CMS FHIR Quality Measure Development IG, published by Centers for Medicare & Medicaid Services (CMS). 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/cqframework/cms-qmd/ and changes regularly. See the Directory of published versions

Communication

Communication

Communication

The QI-Core Communication profile represents information transmitted from a sender to a receiver. It reflects communication about or with the patient.

Important distinction: If the measure intent is to represent patient education or other clinical actions, authors should use the Procedure profile instead. “An action that is being or was performed on a patient” such as training or counseling e.g., involves verification of the patient’s comprehension or aims to change the patient’s mental state.

By default, Communication resources in QI-Core are characterized by the topic element. In comparison to STU 4.1.1, there are no new communication profiles added to STU6 of QI-Core.

CQL:
define "Lab Results Communicated":
   [Communication: "report-labs"] LabReport
       where LabReport.topic = 'report-labs'
       and LabReport.status = 'completed'
       and exists (LabReport.reasonCode  reason
	   where reason ~ 'Serum pregnancy test negative (finding)')

NOTES: The Communication profile does not fix the value of the status element, authors must consider all the possible values for the element to ensure the expression meets measure intent.

.reasonCode, in the example above, this expression uses a direct-reference code of “Serum pregnancy test negative (finding)” (i.e. referencing a specific code from a code system, rather than a value set consisting of multiple codes). For more information on using direct-reference codes in CQL expressions, refer to the Codes topic in the Using CQL with FHIR IG.

Communication Not Done

QI-Core defines the CommunicationNotDone to represent documentation of the reason a communication was not done. By default, CommunicationNotDone resources in QI-Core are characterized by the topic element.

CQL:
define "Medication Not Available":
[CommunicationNotDone: code ~ "progress update (procedure)"] ProgressUpdate 
    where ProgressUpdate.topic ~ "Medication not available (finding)"
    and ProgressUpdate.status = 'completed'
    and exists (ProgressUpdate.reasonCode = Reason
	where Reason = 'Medication not available from manufacturer (finding)')

NOTES: The CommunicationNotDone profile fixes the value of the status element to not-done, this element does not need to be tested in the expression.

Direct-reference codes cannot be used as the terminology target of a retrieve of a negation profile. Workarounds Include:

• placing the code in a single code value set
• using the full long hand logical expression instead of the shorthand expression