Data Exchange For Quality Measures STU3 for FHIR R4
2.1.0 - Ballot

This page is part of the Da Vinci Data Exchange for Quality Measures (DEQM) FHIR IG (v2.1.0: STU 3) based on FHIR R4. The current version which supercedes this version is 3.1.0. For a full list of available versions, see the Directory of published versions

Resource Profile: DEQMPractitionerProfile

The DEQM Practitioner Profile defines the constraints for representing the practitioner who performed the measure or to which is attesting.

The official URL for this profile is: 

http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/practitioner-deqm

Mandatory Data Elements and Terminology

The following data-elements are mandatory (i.e data MUST be present).

Each Practitioner must have:

  1. Either a National Provider Identifier (NPI), or CMS Certification Number(CCN) identifier

Additional Profile specific implementation guidance:

The “Full View” tab below displays all the identifier slices including the CCN slice defined in this guide and NPI slice which is inherited indirectly from the [US Core Practitioner Profile].

Examples

  • Practitioner/practitioner01
  • Practitioner/practitioner02
  • Practitioner/practitioner03

    • Formal Views of Profile Content

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

    This structure is derived from QICorePractitioner

    Summary

    Mandatory: 1 element
    Must-Support: 2 elements

    Slices

    This structure defines the following Slices:

    • The element Practitioner.identifier is sliced based on the value of pattern:$this

    This structure is derived from QICorePractitioner

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Practitioner I0..*QICorePractitionerA person with a formal responsibility in the provisioning of healthcare or related services
    deqm-4: Either an NPI, EIN, or CCN identifier SHALL be present
    ... identifier SI1..*(Slice Definition)An identifier for the person as this agent
    Slice: Unordered, Open by pattern:$this
    .... identifier:ccn S0..1IdentifierAn identifier for the person as this agent
    Required Pattern: At least the following
    ..... system1..1uriThe namespace for the identifier value
    Fixed Value: urn:oid:2.16.840.1.113883.4.336

    doco Documentation for this format
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Practitioner I0..*QICorePractitionerA person with a formal responsibility in the provisioning of healthcare or related services
    deqm-4: Either an NPI, EIN, or CCN identifier SHALL be present
    ... id Σ0..1stringLogical id of this artifact
    ... meta ΣI0..1MetaMetadata about the resource
    ... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
    ... language I0..1codeLanguage of the resource content
    Binding: CommonLanguages (preferred)
    Max Binding: AllLanguages
    ... text I0..1NarrativeText summary of the resource, for human interpretation
    ... contained 0..*ResourceContained, inline Resources
    ... extension I0..*ExtensionAdditional content defined by implementations
    ... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
    ... identifier SΣI1..*(Slice Definition)An identifier for the person as this agent
    Slice: Unordered, Open by pattern:$this
    .... identifier:NPI SΣI0..1IdentifierAn identifier for the person as this agent

    Required Pattern: At least the following
    ..... id0..1stringUnique id for inter-element referencing
    ..... extension0..*ExtensionAdditional content defined by implementations
    ..... use0..1codeusual | official | temp | secondary | old (If known)
    ..... type0..1CodeableConceptDescription of identifier
    ..... system1..1uriThe namespace for the identifier value
    Fixed Value: http://hl7.org/fhir/sid/us-npi
    ..... value0..1stringThe value that is unique
    ..... period0..1PeriodTime period when id is/was valid for use
    ..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
    .... identifier:ccn SΣI0..1IdentifierAn identifier for the person as this agent

    Required Pattern: At least the following
    ..... id0..1stringUnique id for inter-element referencing
    ..... extension0..*ExtensionAdditional content defined by implementations
    ..... use0..1codeusual | official | temp | secondary | old (If known)
    ..... type0..1CodeableConceptDescription of identifier
    ..... system1..1uriThe namespace for the identifier value
    Fixed Value: urn:oid:2.16.840.1.113883.4.336
    ..... value0..1stringThe value that is unique
    ..... period0..1PeriodTime period when id is/was valid for use
    ..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
    ... active ΣI0..1booleanWhether this practitioner's record is in active use
    ... name SΣI1..1HumanNameThe name(s) associated with the practitioner
    .... id 0..1stringUnique id for inter-element referencing
    .... extension I0..*ExtensionAdditional content defined by implementations
    Slice: Unordered, Open by value:url
    .... use ?!ΣI0..1codeusual | official | temp | nickname | anonymous | old | maiden
    Binding: NameUse (required)
    .... text ΣI0..1stringText representation of the full name
    .... family SΣI1..1stringFamily name (often called 'Surname')
    .... given ΣI0..*stringGiven names (not always 'first'). Includes middle names
    This repeating element order: Given Names appear in the correct order for presenting the name
    .... prefix ΣI0..*stringParts that come before the name
    This repeating element order: Prefixes appear in the correct order for presenting the name
    .... suffix ΣI0..*stringParts that come after the name
    This repeating element order: Suffixes appear in the correct order for presenting the name
    .... period ΣI0..1PeriodTime period when name was/is in use
    ... telecom ΣI0..*ContactPointA contact detail for the practitioner (that apply to all roles)
    ... address ΣI0..*AddressAddress(es) of the practitioner that are not role specific (typically home address)
    ... gender ΣI0..1codemale | female | other | unknown
    Binding: AdministrativeGender (required)
    ... birthDate ΣI0..1dateThe date on which the practitioner was born
    ... photo I0..*AttachmentImage of the person
    ... qualification I0..*BackboneElementCertification, licenses, or training pertaining to the provision of care
    .... id 0..1stringUnique id for inter-element referencing
    .... extension I0..*ExtensionAdditional content defined by implementations
    .... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... identifier I0..*IdentifierAn identifier for this qualification for the practitioner
    .... code I1..1CodeableConceptCoded representation of the qualification
    Binding: v2 table 0360, Version 2.7 (example)
    .... period I0..1PeriodPeriod during which the qualification is valid
    .... issuer I0..1Reference(QICoreOrganization)Organization that regulates and issues the qualification
    ... communication I0..*CodeableConceptA language the practitioner can use in patient communication
    Binding: CommonLanguages (preferred)
    Max Binding: AllLanguages

    doco Documentation for this format
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Practitioner I0..*QICorePractitionerA person with a formal responsibility in the provisioning of healthcare or related services
    deqm-4: Either an NPI, EIN, or CCN identifier SHALL be present
    ... identifier ΣI1..*(Slice Definition)An identifier for the person as this agent
    Slice: Unordered, Open by pattern:$this
    .... identifier:NPI ΣI0..1IdentifierAn identifier for the person as this agent

    Required Pattern: At least the following
    ..... id0..1stringUnique id for inter-element referencing
    ..... extension0..*ExtensionAdditional content defined by implementations
    ..... use0..1codeusual | official | temp | secondary | old (If known)
    ..... type0..1CodeableConceptDescription of identifier
    ..... system1..1uriThe namespace for the identifier value
    Fixed Value: http://hl7.org/fhir/sid/us-npi
    ..... value0..1stringThe value that is unique
    ..... period0..1PeriodTime period when id is/was valid for use
    ..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
    .... identifier:ccn ΣI0..1IdentifierAn identifier for the person as this agent

    Required Pattern: At least the following
    ..... id0..1stringUnique id for inter-element referencing
    ..... extension0..*ExtensionAdditional content defined by implementations
    ..... use0..1codeusual | official | temp | secondary | old (If known)
    ..... type0..1CodeableConceptDescription of identifier
    ..... system1..1uriThe namespace for the identifier value
    Fixed Value: urn:oid:2.16.840.1.113883.4.336
    ..... value0..1stringThe value that is unique
    ..... period0..1PeriodTime period when id is/was valid for use
    ..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
    ... name ΣI1..1HumanNameThe name(s) associated with the practitioner
    .... family ΣI1..1stringFamily name (often called 'Surname')

    doco Documentation for this format

    This structure is derived from QICorePractitioner

    Summary

    Mandatory: 1 element
    Must-Support: 2 elements

    Slices

    This structure defines the following Slices:

    • The element Practitioner.identifier is sliced based on the value of pattern:$this

    Differential View

    This structure is derived from QICorePractitioner

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Practitioner I0..*QICorePractitionerA person with a formal responsibility in the provisioning of healthcare or related services
    deqm-4: Either an NPI, EIN, or CCN identifier SHALL be present
    ... identifier SI1..*(Slice Definition)An identifier for the person as this agent
    Slice: Unordered, Open by pattern:$this
    .... identifier:ccn S0..1IdentifierAn identifier for the person as this agent
    Required Pattern: At least the following
    ..... system1..1uriThe namespace for the identifier value
    Fixed Value: urn:oid:2.16.840.1.113883.4.336

    doco Documentation for this format

    Snapshot View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Practitioner I0..*QICorePractitionerA person with a formal responsibility in the provisioning of healthcare or related services
    deqm-4: Either an NPI, EIN, or CCN identifier SHALL be present
    ... id Σ0..1stringLogical id of this artifact
    ... meta ΣI0..1MetaMetadata about the resource
    ... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
    ... language I0..1codeLanguage of the resource content
    Binding: CommonLanguages (preferred)
    Max Binding: AllLanguages
    ... text I0..1NarrativeText summary of the resource, for human interpretation
    ... contained 0..*ResourceContained, inline Resources
    ... extension I0..*ExtensionAdditional content defined by implementations
    ... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
    ... identifier SΣI1..*(Slice Definition)An identifier for the person as this agent
    Slice: Unordered, Open by pattern:$this
    .... identifier:NPI SΣI0..1IdentifierAn identifier for the person as this agent

    Required Pattern: At least the following
    ..... id0..1stringUnique id for inter-element referencing
    ..... extension0..*ExtensionAdditional content defined by implementations
    ..... use0..1codeusual | official | temp | secondary | old (If known)
    ..... type0..1CodeableConceptDescription of identifier
    ..... system1..1uriThe namespace for the identifier value
    Fixed Value: http://hl7.org/fhir/sid/us-npi
    ..... value0..1stringThe value that is unique
    ..... period0..1PeriodTime period when id is/was valid for use
    ..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
    .... identifier:ccn SΣI0..1IdentifierAn identifier for the person as this agent

    Required Pattern: At least the following
    ..... id0..1stringUnique id for inter-element referencing
    ..... extension0..*ExtensionAdditional content defined by implementations
    ..... use0..1codeusual | official | temp | secondary | old (If known)
    ..... type0..1CodeableConceptDescription of identifier
    ..... system1..1uriThe namespace for the identifier value
    Fixed Value: urn:oid:2.16.840.1.113883.4.336
    ..... value0..1stringThe value that is unique
    ..... period0..1PeriodTime period when id is/was valid for use
    ..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
    ... active ΣI0..1booleanWhether this practitioner's record is in active use
    ... name SΣI1..1HumanNameThe name(s) associated with the practitioner
    .... id 0..1stringUnique id for inter-element referencing
    .... extension I0..*ExtensionAdditional content defined by implementations
    Slice: Unordered, Open by value:url
    .... use ?!ΣI0..1codeusual | official | temp | nickname | anonymous | old | maiden
    Binding: NameUse (required)
    .... text ΣI0..1stringText representation of the full name
    .... family SΣI1..1stringFamily name (often called 'Surname')
    .... given ΣI0..*stringGiven names (not always 'first'). Includes middle names
    This repeating element order: Given Names appear in the correct order for presenting the name
    .... prefix ΣI0..*stringParts that come before the name
    This repeating element order: Prefixes appear in the correct order for presenting the name
    .... suffix ΣI0..*stringParts that come after the name
    This repeating element order: Suffixes appear in the correct order for presenting the name
    .... period ΣI0..1PeriodTime period when name was/is in use
    ... telecom ΣI0..*ContactPointA contact detail for the practitioner (that apply to all roles)
    ... address ΣI0..*AddressAddress(es) of the practitioner that are not role specific (typically home address)
    ... gender ΣI0..1codemale | female | other | unknown
    Binding: AdministrativeGender (required)
    ... birthDate ΣI0..1dateThe date on which the practitioner was born
    ... photo I0..*AttachmentImage of the person
    ... qualification I0..*BackboneElementCertification, licenses, or training pertaining to the provision of care
    .... id 0..1stringUnique id for inter-element referencing
    .... extension I0..*ExtensionAdditional content defined by implementations
    .... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... identifier I0..*IdentifierAn identifier for this qualification for the practitioner
    .... code I1..1CodeableConceptCoded representation of the qualification
    Binding: v2 table 0360, Version 2.7 (example)
    .... period I0..1PeriodPeriod during which the qualification is valid
    .... issuer I0..1Reference(QICoreOrganization)Organization that regulates and issues the qualification
    ... communication I0..*CodeableConceptA language the practitioner can use in patient communication
    Binding: CommonLanguages (preferred)
    Max Binding: AllLanguages

    doco Documentation for this format

     

    Other representations of profile: Schematron

    Terminology Bindings

    PathConformanceValueSet
    Practitioner.languagepreferredCommonLanguages
    Max Binding: AllLanguages
    Practitioner.name.userequiredNameUse
    Practitioner.genderrequiredAdministrativeGender
    Practitioner.qualification.codeexamplev2.0360.2.7
    Practitioner.communicationpreferredCommonLanguages
    Max Binding: AllLanguages

    Constraints

    IdPathDetailsRequirements
    deqm-4PractitionerEither an NPI, EIN, or CCN identifier SHALL be present
    : (identifier.system contains 'urn:oid:2.16.840.1.113883.4.4') or (identifier.system contains 'urn:oid:2.16.840.1.113883.4.336') or (identifier.system contains 'http://hl7.org/fhir/sid/us-npi')

    Notes: