Data Exchange For Quality Measures STU3 for FHIR R4
2.1.0 - Ballot
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 
ONLY the new content for Gaps in Care is in the scope for ballot for the September, 2020 Ballot Cycle.
The Gaps in Care is a powerful report that when used along with other DEQM functionality can result in better care results for the payer, the provider, and most importantly the patient. A simplistic example described below shows its potential power.
In this scenario, a provider has requested a gaps in care report for the Colorectal Cancer Screening Measure from ABC Insurance for their patients using the care-gaps operation. Since the provider does not specify open or closed gaps, both open and closed gaps will be returned as default. The gaps in care report returns two patients. The first patient has an open gap and the second patient has a closed gap.
The first patient with the open gap had a colonoscopy done recently and the ABC Insurance has not yet been made aware of. The provider uses the DEQM Submit Data functionality to update the payer’s database.
Later, the provider runs the same gaps in care report again, both patients now showing as having their Colorectal Cancer Screening Measure gaps closed.
| Resource Type | Profile Name | Link to Profile |
|---|---|---|
| Bundle | DEQM Gaps In Care Bundle Profile | DEQM Gaps In Care Bundle Profile |
| Composition | DEQM Gaps In Care Composition Profile | DEQM Gaps In Care Composition Profile |
| DetectedIssue | DEQM Gaps In Care DetectedIssue Profile | DEQM Gaps In Care DetectedIssue Profile |
| Encounter | QI Core Encounter Profile | QI Core Encounter |
| Library | CQFM Library Profile | CQFM Library |
| Measure | CQFM Measure Profile | CQFM Measure |
| MeasureReport | DEQM Gaps In Care Individual MeasureReport Profile | DEQM Gaps In Care Individual MeasureReport Profile |
| Organization | DEQM Organization Profile | DEQM Organization |
| Patient | QI Core Patient Profile | QI Core Patient |
| Practitioner | DEQM Practitioner Profile | DEQM Practitioner |
| Procedure | QI Core Procedure Profile | QI Core Procedure |
A Client, such as a provider, will use the care-gaps operation to request a Colorectal Cancer Screening measure gaps in care report for his/her patients from the Server, such as a payer. The provider receives the report from the payer system and notices that the report identifies one of the patients as having an open gap. He/she looks at the chart and sees that a colonoscopy was done recently for that patient. He/she then submits a DEQM Data Exchange MeasureReport and the referenced resources required as supporting evidence for the Colorectal Cancer Screening measure to the payer. Later, the provider repeats the care-gaps operation for Colorectal Cancer Screening to ensure the open gaps is now closed for that patient.
The Figure 3-22 shows the workflow for gaps in care.
This section contains an example that begins with a provider requesting a gaps in care report for his/her patients from the payer. The provider receives the report, he/she then submits additional data to the payer for the patient that was identified as having open gaps in the report. He/she then later requests a gaps in care report for these patients again from the payer.
The resource graphs below represent the structure of the resources returned from the first care-gaps operation. Figure 3-23 shows the patient, Gaps Patient01, has an open gap because there were no resources in the payer system that would put her in numerator or denominator exclusion of the Colorectal Cancer Screening measure. The DetectedIssue resource contained in this gaps in care report serves as a flag indicating Gaps Patient01 has an open gap for this measure. Figure 3-24 shows the second patient, Gaps Patient02, that is in the report has a closed gap. The evaluatedResource points to a colonoscopy procedure done in 2018 that had met the numerator criteria and resulted as a closed gap. Notice that there is no DetectedIssue resource present because Gaps Patient02 does not have an open gap.
Scenario: The provider requested a gaps in care report on 2020-06-30, which was for a group of patients (group id 123) for the gaps through period from 2020-01-01 to 2020-12-31. The provider received the report, which includes two patients: gaps-patient01 and gaps-patient02. The report shows that gaps-patient01 has an open gap and gaps-patient02 has a closed gap for Colorectal Cancer Screening.
Get Gaps In Care Report
GET [base]/Measure/$care-gaps?subject=Group/123&periodStart=2020-01-01&periodEnd=2020-12-31
{
"resourceType": "Parameters",
"id": "multiple-gaps-indv-report01",
"parameter": [
{
"name": "return",
"resource": {
"resourceType": "Bundle",
"id": "single-gaps-open-indv-report01",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-bundle-deqm"
]
},
"identifier": {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:a11848c9-c9e4-42fc-8f53-cea03782c3e5"
},
"type": "document",
"timestamp": "2020-06-30T13:08:53+00:00",
"entry": [
{
"fullUrl": "http://example.org/fhir/gaps/Composition/gaps-composition01",
"resource": {
"resourceType": "Composition",
"id": "gaps-composition01",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-composition-deqm"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-composition01</p><p><b>meta</b>: </p><p><b>status</b>: final</p><p><b>type</b>: <span title=\"Codes: {http://hl7.org/fhir/us/davinci-deqm/CodeSystem/gaps-doc-type gaps-doc}\">Gaps in Care Report</span></p><p><b>date</b>: Jun 30, 2020, 7:08:53 AM</p><p><b>author</b>: <a href=\"Organization-gaps-organization-reportingvendor.html\">Generated Summary: id: gaps-organization-reportingvendor; Tax ID number = 123446789 (OFFICIAL); active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type pay}\">Payer</span>; name: GapsReportingVendor01; ph: (+1) 401-545-1212</a></p><p><b>title</b>: Care Gap Report for patient gaps-patient01</p></div>"
},
"status": "final",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-deqm/CodeSystem/gaps-doc-type",
"code": "gaps-doc",
"display": "Gaps in Care Report"
}
]
},
"subject": {
"reference": "Patient/gaps-patient01"
},
"date": "2020-06-30T13:08:53+00:00",
"author": [
{
"reference": "Organization/gaps-organization-reportingvendor"
}
],
"title": "Care Gap Report for patient gaps-patient01",
"section": [
{
"title": "Colorectal Cancer Screening",
"focus": {
"reference": "MeasureReport/gaps-indv-measurereport01"
},
"entry": [
{
"reference": "DetectedIssue/gaps-detectedissue01"
}
]
},
{
"title": "Cervical Cancer Screening",
"focus": {
"reference": "MeasureReport/gaps-indv-measurereport02"
},
"entry": [
{
"reference": "DetectedIssue/gaps-detectedissue02"
}
]
}
]
}
},
{
"fullUrl": "http://example.org/fhir/gaps/MeasureReport/gaps-indv-measurereport01",
"resource": {
"resourceType": "MeasureReport",
"id": "gaps-indv-measurereport01",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-indv-measurereport-deqm"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-indv-measurereport01</p><p><b>meta</b>: </p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm130-example\">http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm130-example</a></p><p><b>subject</b>: <a href=\"Patient-gaps-patient01.html\">Generated Summary: id: gaps-patient01; Medical Record Number = 999995992 (USUAL); Parker Susan ; gender: female; birthDate: 1965-01-01</a></p><p><b>date</b>: Jun 30, 2020, 7:08:52 AM</p><p><b>reporter</b>: <a href=\"Organization-organization01.html\">Generated Summary: id: organization01; Tax ID number = 123456789 (OFFICIAL); active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: DaVinciHospital01; ph: (+1) 401-555-1212</a></p><p><b>period</b>: Dec 31, 2019, 5:00:00 PM --> Dec 30, 2020, 5:00:00 PM</p><p><b>improvementNotation</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-improvement-notation increase}\">Increased score indicates improvement</span></p><blockquote><p><b>group</b></p><p><b>id</b>: group-exm130</p><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population initial-population}\">Initial Population</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population numerator}\">Numerator</span></p><p><b>count</b>: 0</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population denominator}\">Denominator</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population denominator-exclusion}\">Denominator Exclusion</span></p><p><b>count</b>: 0</p></blockquote><p><b>measureScore</b>: 0.0</p></blockquote><p><b>evaluatedResource</b>: </p><ul><li><a href=\"Encounter-gaps-encounter01.html\">Generated Summary: id: gaps-encounter01; status: finished; <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode AMB}\">ambulatory</span>; <span title=\"Codes: {http://www.ama-assn.org/go/cpt 99201}\">Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.</span>; period: May 29, 2020, 6:00:00 PM --> May 30, 2020, 6:00:00 PM</a></li><li><a href=\"Patient-gaps-patient01.html\">Generated Summary: id: gaps-patient01; Medical Record Number = 999995992 (USUAL); Parker Susan ; gender: female; birthDate: 1965-01-01</a></li></ul></div>"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code": "proportion"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-certificationIdentifier",
"valueIdentifier": {
"system": "urn:oid:2.16.840.1.113883.3.2074.1",
"value": "0015HQN9BD3304E"
}
},
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-reportingVendor",
"valueReference": {
"reference": "Organization/gaps-organization-reportingvendor"
}
}
],
"status": "complete",
"type": "individual",
"measure": "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm130-example",
"subject": {
"reference": "Patient/gaps-patient01"
},
"date": "2020-06-30T13:08:52+00:00",
"reporter": {
"reference": "Organization/organization01"
},
"period": {
"start": "2020-01-01T00:00:00+00:00",
"end": "2020-12-31T00:00:00+00:00"
},
"improvementNotation": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code": "increase"
}
]
},
"group": [
{
"id": "group-exm130",
"population": [
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "initial-population",
"display": "Initial Population"
}
]
},
"count": 1
},
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "numerator",
"display": "Numerator"
}
]
},
"count": 0
},
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "denominator",
"display": "Denominator"
}
]
},
"count": 1
},
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "denominator-exclusion",
"display": "Denominator Exclusion"
}
]
},
"count": 0
}
],
"measureScore": {
"value": 0.0
}
}
],
"evaluatedResource": [
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-populationReference",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "initial-population"
}
]
}
}
],
"reference": "Encounter/gaps-encounter01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-populationReference",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "initial-population"
}
]
}
}
],
"reference": "Patient/gaps-patient01"
}
]
}
},
{
"fullUrl": "http://example.org/fhir/gaps/MeasureReport/gaps-indv-measurereport02",
"resource": {
"resourceType": "MeasureReport",
"id": "gaps-indv-measurereport02",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-indv-measurereport-deqm"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-indv-measurereport02</p><p><b>meta</b>: </p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm124-example\">http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm124-example</a></p><p><b>subject</b>: <a href=\"Patient-gaps-patient01.html\">Generated Summary: id: gaps-patient01; Medical Record Number = 999995992 (USUAL); Parker Susan ; gender: female; birthDate: 1965-01-01</a></p><p><b>date</b>: Jul 2, 2020, 7:08:52 AM</p><p><b>reporter</b>: <a href=\"Organization-organization01.html\">Generated Summary: id: organization01; Tax ID number = 123456789 (OFFICIAL); active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: DaVinciHospital01; ph: (+1) 401-555-1212</a></p><p><b>period</b>: Dec 31, 2019, 5:00:00 PM --> Dec 30, 2020, 5:00:00 PM</p><p><b>improvementNotation</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-improvement-notation increase}\">Increased score indicates improvement</span></p><blockquote><p><b>group</b></p><p><b>id</b>: group-exm124</p><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population initial-population}\">Initial Population</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population numerator}\">Numerator</span></p><p><b>count</b>: 0</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population denominator}\">Denominator</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population denominator-exclusion}\">Denominator Exclusion</span></p><p><b>count</b>: 0</p></blockquote><p><b>measureScore</b>: 0.0</p></blockquote><p><b>evaluatedResource</b>: </p><ul><li><a href=\"Encounter-gaps-encounter01.html\">Generated Summary: id: gaps-encounter01; status: finished; <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode AMB}\">ambulatory</span>; <span title=\"Codes: {http://www.ama-assn.org/go/cpt 99201}\">Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.</span>; period: May 29, 2020, 6:00:00 PM --> May 30, 2020, 6:00:00 PM</a></li><li><a href=\"Patient-gaps-patient01.html\">Generated Summary: id: gaps-patient01; Medical Record Number = 999995992 (USUAL); Parker Susan ; gender: female; birthDate: 1965-01-01</a></li></ul></div>"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code": "proportion"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-certificationIdentifier",
"valueIdentifier": {
"system": "urn:oid:2.16.840.1.113883.3.2074.1",
"value": "0015HQN9BD3304E"
}
},
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-reportingVendor",
"valueReference": {
"reference": "Organization/gaps-organization-reportingvendor"
}
}
],
"status": "complete",
"type": "individual",
"measure": "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm124-example",
"subject": {
"reference": "Patient/gaps-patient01"
},
"date": "2020-07-02T13:08:52+00:00",
"reporter": {
"reference": "Organization/organization01"
},
"period": {
"start": "2020-01-01T00:00:00+00:00",
"end": "2020-12-31T00:00:00+00:00"
},
"improvementNotation": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code": "increase"
}
]
},
"group": [
{
"id": "group-exm124",
"population": [
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "initial-population",
"display": "Initial Population"
}
]
},
"count": 1
},
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "numerator",
"display": "Numerator"
}
]
},
"count": 0
},
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "denominator",
"display": "Denominator"
}
]
},
"count": 1
},
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "denominator-exclusion",
"display": "Denominator Exclusion"
}
]
},
"count": 0
}
],
"measureScore": {
"value": 0.0
}
}
],
"evaluatedResource": [
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-populationReference",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "initial-population"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-populationReference",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "denominator"
}
]
}
}
],
"reference": "Encounter/gaps-encounter01"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-populationReference",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "initial-population"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-populationReference",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "denominator"
}
]
}
}
],
"reference": "Patient/gaps-patient01"
}
]
}
},
{
"fullUrl": "http://example.org/fhir/gaps/DetectedIssue/gaps-detectedissue01",
"resource": {
"resourceType": "DetectedIssue",
"id": "gaps-detectedissue01",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-detectedissue-deqm"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-detectedissue01</p><p><b>meta</b>: </p><p><b>status</b>: final</p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/detectedissue-category care-gap}\">Gap in Care Detected</span></p><p><b>patient</b>: <a href=\"Patient-gaps-patient01.html\">Generated Summary: id: gaps-patient01; Medical Record Number = 999995992 (USUAL); Parker Susan ; gender: female; birthDate: 1965-01-01</a></p><h3>Evidences</h3><table class=\"grid\"><tr><td>-</td><td><b>Detail</b></td></tr><tr><td>*</td><td><a href=\"MeasureReport-gaps-indv-measurereport01.html\">Generated Summary: id: gaps-indv-measurereport01; status: complete; type: individual; measure: http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm130-FHIR; date: Jul 2, 2020, 7:08:52 AM; period: Dec 31, 2018, 5:00:00 PM --> Dec 30, 2019, 5:00:00 PM; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-improvement-notation increase}\">Increased score indicates improvement</span></a></td></tr></table></div>"
},
"status": "final",
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/detectedissue-category",
"code": "care-gap",
"display": "Gap in Care Detected"
}
]
},
"patient": {
"reference": "Patient/gaps-patient01"
},
"evidence": [
{
"detail": [
{
"reference": "MeasureReport/gaps-indv-measurereport01"
}
]
}
]
}
},
{
"fullUrl": "http://example.org/fhir/gaps/DetectedIssue/gaps-detectedissue02",
"resource": {
"resourceType": "DetectedIssue",
"id": "gaps-detectedissue02",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-detectedissue-deqm"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-detectedissue02</p><p><b>meta</b>: </p><p><b>status</b>: final</p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/detectedissue-category care-gap}\">Gap in Care Detected</span></p><p><b>patient</b>: <a href=\"Patient-gaps-patient01.html\">Generated Summary: id: gaps-patient01; Medical Record Number = 999995992 (USUAL); Parker Susan ; gender: female; birthDate: 1965-01-01</a></p><h3>Evidences</h3><table class=\"grid\"><tr><td>-</td><td><b>Detail</b></td></tr><tr><td>*</td><td><a href=\"MeasureReport-gaps-indv-measurereport02.html\">Generated Summary: id: gaps-indv-measurereport02; status: complete; type: individual; measure: http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm124-FHIR; date: Jul 2, 2020, 7:08:52 AM; period: Dec 31, 2018, 5:00:00 PM --> Dec 30, 2019, 5:00:00 PM; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-improvement-notation increase}\">Increased score indicates improvement</span></a></td></tr></table></div>"
},
"status": "final",
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/detectedissue-category",
"code": "care-gap",
"display": "Gap in Care Detected"
}
]
},
"patient": {
"reference": "Patient/gaps-patient01"
},
"evidence": [
{
"detail": [
{
"reference": "MeasureReport/gaps-indv-measurereport02"
}
]
}
]
}
},
{
"fullUrl": "http://example.org/fhir/gaps/Encounter/gaps-encounter01",
"resource": {
"resourceType": "Encounter",
"id": "gaps-encounter01",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-encounter01</p><p><b>meta</b>: </p><p><b>status</b>: finished</p><p><b>class</b>: <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode AMB}\">ambulatory</span></p><p><b>type</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt 99201}\">Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.</span></p><p><b>subject</b>: <a href=\"Patient-gaps-patient01.html\">Generated Summary: id: gaps-patient01; Medical Record Number = 999995992 (USUAL); Parker Susan ; gender: female; birthDate: 1965-01-01</a></p><p><b>period</b>: May 29, 2020, 6:00:00 PM --> May 30, 2020, 6:00:00 PM</p></div>"
},
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB",
"display": "ambulatory"
},
"type": [
{
"coding": [
{
"system": "http://www.ama-assn.org/go/cpt",
"code": "99201",
"display": "Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family."
}
]
}
],
"subject": {
"reference": "Patient/gaps-patient01"
},
"period": {
"start": "2020-05-30T00:00:00-00:00",
"end": "2020-05-31T00:00:00-00:00"
}
}
},
{
"fullUrl": "http://example.org/fhir/gaps/Patient/gaps-patient01",
"resource": {
"resourceType": "Patient",
"id": "gaps-patient01",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-patient01</p><p><b>meta</b>: </p><p><b>identifier</b>: Medical Record Number = 999995992 (USUAL)</p><p><b>name</b>: Parker Susan </p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1965-01-01</p></div>"
},
"extension": [
{
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2028-9",
"display": "Asian"
}
},
{
"url": "text",
"valueString": "Asian"
}
],
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
},
{
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2135-2",
"display": "Hispanic or Latino"
}
},
{
"url": "text",
"valueString": "Hispanic or Latino"
}
],
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
}
],
"identifier": [
{
"use": "usual",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "MR",
"display": "Medical Record Number"
}
]
},
"system": "http://hospital.smarthealthit.org",
"value": "999995992"
}
],
"name": [
{
"family": "Susan",
"given": [
"Parker"
]
}
],
"gender": "female",
"birthDate": "1965-01-01"
}
},
{
"fullUrl": "http://example.org/fhir/gaps/Organization/gaps-organization-reportingvendor",
"resource": {
"resourceType": "Organization",
"id": "gaps-organization-reportingvendor",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-organization-reportingvendor</p><p><b>meta</b>: </p><p><b>identifier</b>: Tax ID number = 123446789 (OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type pay}\">Payer</span></p><p><b>name</b>: GapsReportingVendor01</p><p><b>telecom</b>: ph: (+1) 401-545-1212</p><p><b>address</b>: 13 ABC Street Whoville MA 01101 USA </p></div>"
},
"identifier": [
{
"use": "official",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "TAX",
"display": "Tax ID number"
}
]
},
"system": "urn:oid:2.16.840.1.113883.4.4",
"value": "123446789",
"assigner": {
"display": "www.irs.gov"
}
}
],
"active": true,
"type": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/organization-type",
"code": "pay",
"display": "Payer"
}
]
}
],
"name": "GapsReportingVendor01",
"telecom": [
{
"system": "phone",
"value": "(+1) 401-545-1212"
}
],
"address": [
{
"line": [
"13 ABC Street"
],
"city": "Whoville",
"state": "MA",
"postalCode": "01101",
"country": "USA"
}
]
}
}
]
}
},
{
"name": "return",
"resource": {
"resourceType": "Bundle",
"id": "single-gaps-closed-indv-report01",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-bundle-deqm"
]
},
"identifier": {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:66556327-43dc-40fc-b20c-4e31a31e98e0"
},
"type": "document",
"timestamp": "2020-06-30T13:08:53+00:00",
"entry": [
{
"fullUrl": "http://example.org/fhir/gaps/Composition/gaps-composition02",
"resource": {
"resourceType": "Composition",
"id": "gaps-composition02",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-composition-deqm"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-composition02</p><p><b>meta</b>: </p><p><b>status</b>: final</p><p><b>type</b>: <span title=\"Codes: {http://hl7.org/fhir/us/davinci-deqm/CodeSystem/gaps-doc-type gaps-doc}\">Gaps in Care Report</span></p><p><b>date</b>: Jun 30, 2020, 7:08:53 AM</p><p><b>author</b>: <a href=\"Organization-gaps-organization-reportingvendor.html\">Generated Summary: id: gaps-organization-reportingvendor; Tax ID number = 123446789 (OFFICIAL); active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type pay}\">Payer</span>; name: GapsReportingVendor01; ph: (+1) 401-545-1212</a></p><p><b>title</b>: Care Gap Report for patient gaps-patient02</p></div>"
},
"status": "final",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-deqm/CodeSystem/gaps-doc-type",
"code": "gaps-doc",
"display": "Gaps in Care Report"
}
]
},
"subject": {
"reference": "Patient/gaps-patient02"
},
"date": "2020-06-30T13:08:53+00:00",
"author": [
{
"reference": "Organization/gaps-organization-reportingvendor"
}
],
"title": "Care Gap Report for patient gaps-patient02",
"section": [
{
"title": "Colorectal Cancer Screening",
"focus": {
"reference": "MeasureReport/gaps-indv-measurereport03"
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>No detected issues.</p></div>"
}
}
]
}
},
{
"fullUrl": "http://example.org/fhir/gaps/MeasureReport/gaps-indv-measurereport03",
"resource": {
"resourceType": "MeasureReport",
"id": "gaps-indv-measurereport03",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-indv-measurereport-deqm"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-indv-measurereport03</p><p><b>meta</b>: </p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm130-example\">http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm130-example</a></p><p><b>subject</b>: <a href=\"Patient-gaps-patient02.html\">Generated Summary: id: gaps-patient02; Medical Record Number = 999996992 (USUAL); Thomas Ludwich ; gender: male; birthDate: 1957-01-01</a></p><p><b>date</b>: Jun 30, 2020, 7:08:52 AM</p><p><b>reporter</b>: <a href=\"Organization-organization01.html\">Generated Summary: id: organization01; Tax ID number = 123456789 (OFFICIAL); active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: DaVinciHospital01; ph: (+1) 401-555-1212</a></p><p><b>period</b>: Dec 31, 2019, 5:00:00 PM --> Dec 30, 2020, 5:00:00 PM</p><p><b>improvementNotation</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-improvement-notation increase}\">Increased score indicates improvement</span></p><blockquote><p><b>group</b></p><p><b>id</b>: group-exm130</p><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population initial-population}\">Initial Population</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population numerator}\">Numerator</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population denominator}\">Denominator</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population denominator-exclusion}\">Denominator Exclusion</span></p><p><b>count</b>: 0</p></blockquote><p><b>measureScore</b>: 1.0</p></blockquote><p><b>evaluatedResource</b>: </p><ul><li><a href=\"Encounter-gaps-encounter02.html\">Generated Summary: id: gaps-encounter02; status: finished; <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode AMB}\">ambulatory</span>; <span title=\"Codes: {http://www.ama-assn.org/go/cpt 99201}\">Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.</span>; period: Sep 10, 2018, 1:00:00 AM --> Sep 10, 2018, 4:00:00 AM</a></li><li><a href=\"Patient-gaps-patient02.html\">Generated Summary: id: gaps-patient02; Medical Record Number = 999996992 (USUAL); Thomas Ludwich ; gender: male; birthDate: 1957-01-01</a></li></ul></div>"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code": "proportion"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-certificationIdentifier",
"valueIdentifier": {
"system": "urn:oid:2.16.840.1.113883.3.2074.1",
"value": "0015HQN9BD3304E"
}
},
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-reportingVendor",
"valueReference": {
"reference": "Organization/gaps-organization-reportingvendor"
}
}
],
"status": "complete",
"type": "individual",
"measure": "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm130-example",
"subject": {
"reference": "Patient/gaps-patient02"
},
"date": "2020-06-30T13:08:52+00:00",
"reporter": {
"reference": "Organization/organization01"
},
"period": {
"start": "2020-01-01T00:00:00+00:00",
"end": "2020-12-31T00:00:00+00:00"
},
"improvementNotation": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code": "increase"
}
]
},
"group": [
{
"id": "group-exm130",
"population": [
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "initial-population",
"display": "Initial Population"
}
]
},
"count": 1
},
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "numerator",
"display": "Numerator"
}
]
},
"count": 1
},
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "denominator",
"display": "Denominator"
}
]
},
"count": 1
},
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "denominator-exclusion",
"display": "Denominator Exclusion"
}
]
},
"count": 0
}
],
"measureScore": {
"value": 1.0
}
}
],
"evaluatedResource": [
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-populationReference",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "initial-population"
}
]
}
}
],
"reference": "Encounter/gaps-encounter02"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-populationReference",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "initial-population"
}
]
}
}
],
"reference": "Patient/gaps-patient02"
}
]
}
},
{
"fullUrl": "http://example.org/fhir/gaps/Encounter/gaps-encounter02",
"resource": {
"resourceType": "Encounter",
"id": "gaps-encounter02",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-encounter02</p><p><b>meta</b>: </p><p><b>status</b>: finished</p><p><b>class</b>: <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode AMB}\">ambulatory</span></p><p><b>type</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt 99201}\">Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.</span></p><p><b>subject</b>: <a href=\"Patient-gaps-patient02.html\">Generated Summary: id: gaps-patient02; Medical Record Number = 999996992 (USUAL); Thomas Ludwich ; gender: male; birthDate: 1957-01-01</a></p><p><b>period</b>: Sep 10, 2018, 1:00:00 AM --> Sep 10, 2018, 4:00:00 AM</p></div>"
},
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB",
"display": "ambulatory"
},
"type": [
{
"coding": [
{
"system": "http://www.ama-assn.org/go/cpt",
"code": "99201",
"display": "Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family."
}
]
}
],
"subject": {
"reference": "Patient/gaps-patient02"
},
"period": {
"start": "2018-09-10T07:00:00-00:00",
"end": "2018-09-10T10:00:00-00:00"
}
}
},
{
"fullUrl": "http://example.org/fhir/gaps/Procedure/gaps-procedure01",
"resource": {
"resourceType": "Procedure",
"id": "gaps-procedure01",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-procedure01</p><p><b>meta</b>: </p><p><b>status</b>: completed</p><p><b>code</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt 44393}\">Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique</span></p><p><b>subject</b>: <a href=\"Patient-gaps-patient02.html\">Generated Summary: id: gaps-patient02; Medical Record Number = 999996992 (USUAL); Thomas Ludwich ; gender: male; birthDate: 1957-01-01</a></p><p><b>performed</b>: Sep 10, 2018, 2:00:00 AM --> Sep 10, 2018, 3:00:00 AM</p></div>"
},
"status": "completed",
"code": {
"coding": [
{
"system": "http://www.ama-assn.org/go/cpt",
"code": "44393",
"display": "Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique"
}
]
},
"subject": {
"reference": "Patient/gaps-patient02"
},
"performedPeriod": {
"start": "2018-09-10T08:00:00-00:00",
"end": "2018-09-10T09:00:00-00:00"
}
}
},
{
"fullUrl": "http://example.org/fhir/gaps/Patient/gaps-patient02",
"resource": {
"resourceType": "Patient",
"id": "gaps-patient02",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-patient02</p><p><b>meta</b>: </p><p><b>identifier</b>: Medical Record Number = 999996992 (USUAL)</p><p><b>name</b>: Thomas Ludwich </p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1957-01-01</p></div>"
},
"extension": [
{
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2028-9",
"display": "Asian"
}
},
{
"url": "text",
"valueString": "Asian"
}
],
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
},
{
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2135-2",
"display": "Hispanic or Latino"
}
},
{
"url": "text",
"valueString": "Hispanic or Latino"
}
],
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
}
],
"identifier": [
{
"use": "usual",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "MR",
"display": "Medical Record Number"
}
]
},
"system": "http://hospital.smarthealthit.org",
"value": "999996992"
}
],
"name": [
{
"family": "Ludwich",
"given": [
"Thomas"
]
}
],
"gender": "male",
"birthDate": "1957-01-01"
}
},
{
"fullUrl": "http://example.org/fhir/gaps/Organization/gaps-organization-reportingvendor",
"resource": {
"resourceType": "Organization",
"id": "gaps-organization-reportingvendor",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-organization-reportingvendor</p><p><b>meta</b>: </p><p><b>identifier</b>: Tax ID number = 123446789 (OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type pay}\">Payer</span></p><p><b>name</b>: GapsReportingVendor01</p><p><b>telecom</b>: ph: (+1) 401-545-1212</p><p><b>address</b>: 13 ABC Street Whoville MA 01101 USA </p></div>"
},
"identifier": [
{
"use": "official",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "TAX",
"display": "Tax ID number"
}
]
},
"system": "urn:oid:2.16.840.1.113883.4.4",
"value": "123446789",
"assigner": {
"display": "www.irs.gov"
}
}
],
"active": true,
"type": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/organization-type",
"code": "pay",
"display": "Payer"
}
]
}
],
"name": "GapsReportingVendor01",
"telecom": [
{
"system": "phone",
"value": "(+1) 401-545-1212"
}
],
"address": [
{
"line": [
"13 ABC Street"
],
"city": "Whoville",
"state": "MA",
"postalCode": "01101",
"country": "USA"
}
]
}
}
]
}
}
]
}
The provider noticed Gaps Patient01 was indicated as having an open gap for Colorectal Cancer Screening. The provider ordered an colonscopy and the patient was able to get it done in the next few days. Since the payer system did not have this new data, the provider then used the DEQM Data Exchange profile(s) to submit additional data to the payer. Please see Colorectal Cancer Screening (COL) Use Case for details on how to complete the DEQM Data Exchange.
The provider rerun the Colorectal Cancer Screening gaps in care report and confirmed that the open gap for Gaps Patient01 was closed. Note that in the Figure 3-25 below, Gaps Patient01 no longer has a DetectedIssue, because the open gap is now closed. The Gaps Patient01 shows a recent colonoscopy. Figure 3-26 shows that there are no changes to Gaps Patient02 comparing to the initially generated report, it still shows closed gap.
Scenario: After additional data was submitted to the payer system. The provider requested a gaps in care report again on 2020-07-07 for the same group of patients (group id 123) and for the same gaps through period from 2020-01-01 to 2020-12-31. The provider received the report. It showed that gaps-patient01 now has a closed gap for Colorectal Cancer Screening and the gaps-patient02 still has a closed gap.
Get Gaps In Care Report
GET [base]/Measure/$care-gaps?subject=Group/123&periodStart=2020-01-01&periodEnd=2020-12-31
{
"resourceType": "Parameters",
"id": "multiple-gaps-indv-report02",
"parameter": [
{
"name": "return",
"resource": {
"resourceType": "Bundle",
"id": "single-gaps-closed-indv-report02",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-bundle-deqm"
]
},
"identifier": {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:7396eb14-8f5c-4fe1-b023-1c6838152136"
},
"type": "document",
"timestamp": "2020-07-07T13:08:53+00:00",
"entry": [
{
"fullUrl": "http://example.org/fhir/gaps/Composition/gaps-composition03",
"resource": {
"resourceType": "Composition",
"id": "gaps-composition03",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-composition-deqm"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-composition03</p><p><b>meta</b>: </p><p><b>status</b>: final</p><p><b>type</b>: <span title=\"Codes: {http://hl7.org/fhir/us/davinci-deqm/CodeSystem/gaps-doc-type gaps-doc}\">Gaps in Care Report</span></p><p><b>date</b>: Jul 7, 2020, 7:08:53 AM</p><p><b>author</b>: <a href=\"Organization-gaps-organization-reportingvendor.html\">Generated Summary: id: gaps-organization-reportingvendor; Tax ID number = 123446789 (OFFICIAL); active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type pay}\">Payer</span>; name: GapsReportingVendor01; ph: (+1) 401-545-1212</a></p><p><b>title</b>: Care Gap Report for patient gaps-patient01</p></div>"
},
"status": "final",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-deqm/CodeSystem/gaps-doc-type",
"code": "gaps-doc",
"display": "Gaps in Care Report"
}
]
},
"subject": {
"reference": "Patient/gaps-patient01"
},
"date": "2020-07-07T13:08:53+00:00",
"author": [
{
"reference": "Organization/gaps-organization-reportingvendor"
}
],
"title": "Care Gap Report for patient gaps-patient01",
"section": [
{
"title": "Colorectal Cancer Screening",
"focus": {
"reference": "MeasureReport/gaps-indv-measurereport04"
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>No detected issues.</p></div>"
}
}
]
}
},
{
"fullUrl": "http://example.org/fhir/gaps/MeasureReport/gaps-indv-measurereport04",
"resource": {
"resourceType": "MeasureReport",
"id": "gaps-indv-measurereport04",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-indv-measurereport-deqm"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-indv-measurereport04</p><p><b>meta</b>: </p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm130-example\">http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm130-example</a></p><p><b>subject</b>: <a href=\"Patient-gaps-patient01.html\">Generated Summary: id: gaps-patient01; Medical Record Number = 999995992 (USUAL); Parker Susan ; gender: male; birthDate: 1965-01-01</a></p><p><b>date</b>: Jul 7, 2020, 7:08:52 AM</p><p><b>reporter</b>: <a href=\"Organization-organization01.html\">Generated Summary: id: organization01; Tax ID number = 123456789 (OFFICIAL); active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: DaVinciHospital01; ph: (+1) 401-555-1212</a></p><p><b>period</b>: Dec 31, 2019, 5:00:00 PM --> Dec 30, 2020, 5:00:00 PM</p><p><b>improvementNotation</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-improvement-notation increase}\">Increased score indicates improvement</span></p><blockquote><p><b>group</b></p><p><b>id</b>: group-exm130</p><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population initial-population}\">Initial Population</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population numerator}\">Numerator</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population denominator}\">Denominator</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population denominator-exclusion}\">Denominator Exclusion</span></p><p><b>count</b>: 0</p></blockquote><p><b>measureScore</b>: 1.0</p></blockquote><p><b>evaluatedResource</b>: </p><ul><li><a href=\"Encounter-gaps-encounter03.html\">Generated Summary: id: gaps-encounter03; status: finished; <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode AMB}\">ambulatory</span>; <span title=\"Codes: {http://www.ama-assn.org/go/cpt 99201}\">Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.</span>; period: Jul 6, 2020, 1:07:00 AM --> Jul 6, 2020, 4:11:00 AM</a></li><li><a href=\"Patient-gaps-patient01.html\">Generated Summary: id: gaps-patient01; Medical Record Number = 999995992 (USUAL); Parker Susan ; gender: male; birthDate: 1965-01-01</a></li></ul></div>"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code": "proportion"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-certificationIdentifier",
"valueIdentifier": {
"system": "urn:oid:2.16.840.1.113883.3.2074.1",
"value": "0015HQN9BD3304E"
}
},
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-reportingVendor",
"valueReference": {
"reference": "Organization/gaps-organization-reportingvendor"
}
}
],
"status": "complete",
"type": "individual",
"measure": "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm130-example",
"subject": {
"reference": "Patient/gaps-patient01"
},
"date": "2020-07-07T13:08:52+00:00",
"reporter": {
"reference": "Organization/organization01"
},
"period": {
"start": "2020-01-01T00:00:00+00:00",
"end": "2020-12-31T00:00:00+00:00"
},
"improvementNotation": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code": "increase"
}
]
},
"group": [
{
"id": "group-exm130",
"population": [
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "initial-population",
"display": "Initial Population"
}
]
},
"count": 1
},
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "numerator",
"display": "Numerator"
}
]
},
"count": 1
},
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "denominator",
"display": "Denominator"
}
]
},
"count": 1
},
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "denominator-exclusion",
"display": "Denominator Exclusion"
}
]
},
"count": 0
}
],
"measureScore": {
"value": 1.0
}
}
],
"evaluatedResource": [
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-populationReference",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "initial-population"
}
]
}
}
],
"reference": "Encounter/gaps-encounter03"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-populationReference",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "initial-population"
}
]
}
}
],
"reference": "Patient/gaps-patient01"
}
]
}
},
{
"fullUrl": "http://example.org/fhir/gaps/Encounter/gaps-encounter03",
"resource": {
"resourceType": "Encounter",
"id": "gaps-encounter03",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-encounter03</p><p><b>meta</b>: </p><p><b>status</b>: finished</p><p><b>class</b>: <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode AMB}\">ambulatory</span></p><p><b>type</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt 99201}\">Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.</span></p><p><b>subject</b>: <a href=\"Patient-gaps-patient01.html\">Generated Summary: id: gaps-patient01; Medical Record Number = 999995992 (USUAL); Parker Susan ; gender: male; birthDate: 1965-01-01</a></p><p><b>period</b>: Jul 6, 2020, 1:07:00 AM --> Jul 6, 2020, 4:11:00 AM</p></div>"
},
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB",
"display": "ambulatory"
},
"type": [
{
"coding": [
{
"system": "http://www.ama-assn.org/go/cpt",
"code": "99201",
"display": "Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family."
}
]
}
],
"subject": {
"reference": "Patient/gaps-patient01"
},
"period": {
"start": "2020-07-06T07:07:00-00:00",
"end": "2020-07-06T10:11:00-00:00"
}
}
},
{
"fullUrl": "http://example.org/fhir/gaps/Procedure/gaps-procedure02",
"resource": {
"resourceType": "Procedure",
"id": "gaps-procedure02",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-procedure02</p><p><b>meta</b>: </p><p><b>status</b>: completed</p><p><b>code</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt 44393}\">Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique</span></p><p><b>subject</b>: <a href=\"Patient-gaps-patient01.html\">Generated Summary: id: gaps-patient01; Medical Record Number = 999995992 (USUAL); Parker Susan ; gender: male; birthDate: 1965-01-01</a></p><p><b>performed</b>: Jul 6, 2020, 2:00:00 AM --> Jul 6, 2020, 3:00:00 AM</p></div>"
},
"status": "completed",
"code": {
"coding": [
{
"system": "http://www.ama-assn.org/go/cpt",
"code": "44393",
"display": "Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique"
}
]
},
"subject": {
"reference": "Patient/gaps-patient01"
},
"performedPeriod": {
"start": "2020-07-06T08:00:00-00:00",
"end": "2020-07-06T09:00:00-00:00"
}
}
},
{
"fullUrl": "http://example.org/fhir/gaps/Patient/gaps-patient01",
"resource": {
"resourceType": "Patient",
"id": "gaps-patient01",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-patient01</p><p><b>meta</b>: </p><p><b>identifier</b>: Medical Record Number = 999995992 (USUAL)</p><p><b>name</b>: Parker Susan </p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1965-01-01</p></div>"
},
"extension": [
{
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2028-9",
"display": "Asian"
}
},
{
"url": "text",
"valueString": "Asian"
}
],
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
},
{
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2135-2",
"display": "Hispanic or Latino"
}
},
{
"url": "text",
"valueString": "Hispanic or Latino"
}
],
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
}
],
"identifier": [
{
"use": "usual",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "MR",
"display": "Medical Record Number"
}
]
},
"system": "http://hospital.smarthealthit.org",
"value": "999995992"
}
],
"name": [
{
"family": "Susan",
"given": [
"Parker"
]
}
],
"gender": "male",
"birthDate": "1965-01-01"
}
},
{
"fullUrl": "http://example.org/fhir/gaps/Organization/gaps-organization-reportingvendor",
"resource": {
"resourceType": "Organization",
"id": "gaps-organization-reportingvendor",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-organization-reportingvendor</p><p><b>meta</b>: </p><p><b>identifier</b>: Tax ID number = 123446789 (OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type pay}\">Payer</span></p><p><b>name</b>: GapsReportingVendor01</p><p><b>telecom</b>: ph: (+1) 401-545-1212</p><p><b>address</b>: 13 Drive Street Cityplace MA 01101 USA </p></div>"
},
"identifier": [
{
"use": "official",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "TAX",
"display": "Tax ID number"
}
]
},
"system": "urn:oid:2.16.840.1.113883.4.4",
"value": "123446789",
"assigner": {
"display": "www.irs.gov"
}
}
],
"active": true,
"type": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/organization-type",
"code": "pay",
"display": "Payer"
}
]
}
],
"name": "GapsReportingVendor01",
"telecom": [
{
"system": "phone",
"value": "(+1) 401-545-1212"
}
],
"address": [
{
"line": [
"13 Drive Street"
],
"city": "Cityplace",
"state": "MA",
"postalCode": "01101",
"country": "USA"
}
]
}
}
]
}
},
{
"name": "return",
"resource": {
"resourceType": "Bundle",
"id": "single-gaps-closed-indv-report01",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-bundle-deqm"
]
},
"identifier": {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:80c493d0-e3c7-4e63-81fe-81fb3b16b9ab"
},
"type": "document",
"timestamp": "2020-07-07T13:08:53+00:00",
"entry": [
{
"fullUrl": "http://example.org/fhir/gaps/Composition/gaps-composition02",
"resource": {
"resourceType": "Composition",
"id": "gaps-composition02",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-composition-deqm"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-composition02</p><p><b>meta</b>: </p><p><b>status</b>: final</p><p><b>type</b>: <span title=\"Codes: {http://hl7.org/fhir/us/davinci-deqm/CodeSystem/gaps-doc-type gaps-doc}\">Gaps in Care Report</span></p><p><b>date</b>: Jun 30, 2020, 7:08:53 AM</p><p><b>author</b>: <a href=\"Organization-gaps-organization-reportingvendor.html\">Generated Summary: id: gaps-organization-reportingvendor; Tax ID number = 123446789 (OFFICIAL); active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type pay}\">Payer</span>; name: GapsReportingVendor01; ph: (+1) 401-545-1212</a></p><p><b>title</b>: Care Gap Report for patient gaps-patient02</p></div>"
},
"status": "final",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-deqm/CodeSystem/gaps-doc-type",
"code": "gaps-doc",
"display": "Gaps in Care Report"
}
]
},
"subject": {
"reference": "Patient/gaps-patient02"
},
"date": "2020-07-07T13:08:53+00:00",
"author": [
{
"reference": "Organization/gaps-organization-reportingvendor"
}
],
"title": "Care Gap Report for patient gaps-patient02",
"section": [
{
"title": "Colorectal Cancer Screening",
"focus": {
"reference": "MeasureReport/gaps-indv-measurereport03"
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>No detected issues.</p></div>"
}
}
]
}
},
{
"fullUrl": "http://example.org/fhir/gaps/MeasureReport/gaps-indv-measurereport03",
"resource": {
"resourceType": "MeasureReport",
"id": "gaps-indv-measurereport03",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-indv-measurereport-deqm"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-indv-measurereport03</p><p><b>meta</b>: </p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm130-example\">http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm130-example</a></p><p><b>subject</b>: <a href=\"Patient-gaps-patient02.html\">Generated Summary: id: gaps-patient02; Medical Record Number = 999996992 (USUAL); Thomas Ludwich ; gender: male; birthDate: 1957-01-01</a></p><p><b>date</b>: Jun 30, 2020, 7:08:52 AM</p><p><b>reporter</b>: <a href=\"Organization-organization01.html\">Generated Summary: id: organization01; Tax ID number = 123456789 (OFFICIAL); active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: DaVinciHospital01; ph: (+1) 401-555-1212</a></p><p><b>period</b>: Dec 31, 2019, 5:00:00 PM --> Dec 30, 2020, 5:00:00 PM</p><p><b>improvementNotation</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-improvement-notation increase}\">Increased score indicates improvement</span></p><blockquote><p><b>group</b></p><p><b>id</b>: group-exm130</p><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population initial-population}\">Initial Population</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population numerator}\">Numerator</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population denominator}\">Denominator</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population denominator-exclusion}\">Denominator Exclusion</span></p><p><b>count</b>: 0</p></blockquote><p><b>measureScore</b>: 1.0</p></blockquote><p><b>evaluatedResource</b>: </p><ul><li><a href=\"Encounter-gaps-encounter02.html\">Generated Summary: id: gaps-encounter02; status: finished; <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode AMB}\">ambulatory</span>; <span title=\"Codes: {http://www.ama-assn.org/go/cpt 99201}\">Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.</span>; period: Sep 10, 2018, 1:00:00 AM --> Sep 10, 2018, 4:00:00 AM</a></li><li><a href=\"Patient-gaps-patient02.html\">Generated Summary: id: gaps-patient02; Medical Record Number = 999996992 (USUAL); Thomas Ludwich ; gender: male; birthDate: 1957-01-01</a></li></ul></div>"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code": "proportion"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-certificationIdentifier",
"valueIdentifier": {
"system": "urn:oid:2.16.840.1.113883.3.2074.1",
"value": "0015HQN9BD3304E"
}
},
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-reportingVendor",
"valueReference": {
"reference": "Organization/gaps-organization-reportingvendor"
}
}
],
"status": "complete",
"type": "individual",
"measure": "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm130-example",
"subject": {
"reference": "Patient/gaps-patient02"
},
"date": "2020-07-07T13:08:53+00:00",
"reporter": {
"reference": "Organization/organization01"
},
"period": {
"start": "2020-01-01T00:00:00+00:00",
"end": "2020-12-31T00:00:00+00:00"
},
"improvementNotation": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code": "increase"
}
]
},
"group": [
{
"id": "group-exm130",
"population": [
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "initial-population",
"display": "Initial Population"
}
]
},
"count": 1
},
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "numerator",
"display": "Numerator"
}
]
},
"count": 1
},
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "denominator",
"display": "Denominator"
}
]
},
"count": 1
},
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "denominator-exclusion",
"display": "Denominator Exclusion"
}
]
},
"count": 0
}
],
"measureScore": {
"value": 1.0
}
}
],
"evaluatedResource": [
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-populationReference",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "initial-population"
}
]
}
}
],
"reference": "Encounter/gaps-encounter02"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-populationReference",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-population",
"code": "initial-population"
}
]
}
}
],
"reference": "Patient/gaps-patient02"
}
]
}
},
{
"fullUrl": "http://example.org/fhir/gaps/Encounter/gaps-encounter02",
"resource": {
"resourceType": "Encounter",
"id": "gaps-encounter02",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-encounter02</p><p><b>meta</b>: </p><p><b>status</b>: finished</p><p><b>class</b>: <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode AMB}\">ambulatory</span></p><p><b>type</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt 99201}\">Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.</span></p><p><b>subject</b>: <a href=\"Patient-gaps-patient02.html\">Generated Summary: id: gaps-patient02; Medical Record Number = 999996992 (USUAL); Thomas Ludwich ; gender: male; birthDate: 1957-01-01</a></p><p><b>period</b>: Sep 10, 2018, 1:00:00 AM --> Sep 10, 2018, 4:00:00 AM</p></div>"
},
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB",
"display": "ambulatory"
},
"type": [
{
"coding": [
{
"system": "http://www.ama-assn.org/go/cpt",
"code": "99201",
"display": "Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family."
}
]
}
],
"subject": {
"reference": "Patient/gaps-patient02"
},
"period": {
"start": "2018-09-10T07:00:00-00:00",
"end": "2018-09-10T10:00:00-00:00"
}
}
},
{
"fullUrl": "http://example.org/fhir/gaps/Procedure/gaps-procedure01",
"resource": {
"resourceType": "Procedure",
"id": "gaps-procedure01",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-procedure01</p><p><b>meta</b>: </p><p><b>status</b>: completed</p><p><b>code</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt 44393}\">Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique</span></p><p><b>subject</b>: <a href=\"Patient-gaps-patient02.html\">Generated Summary: id: gaps-patient02; Medical Record Number = 999996992 (USUAL); Thomas Ludwich ; gender: male; birthDate: 1957-01-01</a></p><p><b>performed</b>: Sep 10, 2018, 2:00:00 AM --> Sep 10, 2018, 3:00:00 AM</p></div>"
},
"status": "completed",
"code": {
"coding": [
{
"system": "http://www.ama-assn.org/go/cpt",
"code": "44393",
"display": "Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique"
}
]
},
"subject": {
"reference": "Patient/gaps-patient02"
},
"performedPeriod": {
"start": "2018-09-10T08:00:00-00:00",
"end": "2018-09-10T09:00:00-00:00"
}
}
},
{
"fullUrl": "http://example.org/fhir/gaps/Patient/gaps-patient02",
"resource": {
"resourceType": "Patient",
"id": "gaps-patient02",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-patient02</p><p><b>meta</b>: </p><p><b>identifier</b>: Medical Record Number = 999996992 (USUAL)</p><p><b>name</b>: Thomas Ludwich </p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1957-01-01</p></div>"
},
"extension": [
{
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2028-9",
"display": "Asian"
}
},
{
"url": "text",
"valueString": "Asian"
}
],
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
},
{
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2135-2",
"display": "Hispanic or Latino"
}
},
{
"url": "text",
"valueString": "Hispanic or Latino"
}
],
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
}
],
"identifier": [
{
"use": "usual",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "MR",
"display": "Medical Record Number"
}
]
},
"system": "http://hospital.smarthealthit.org",
"value": "999996992"
}
],
"name": [
{
"family": "Ludwich",
"given": [
"Thomas"
]
}
],
"gender": "male",
"birthDate": "1957-01-01"
}
},
{
"fullUrl": "http://example.org/fhir/gaps/Organization/gaps-organization-reportingvendor",
"resource": {
"resourceType": "Organization",
"id": "gaps-organization-reportingvendor",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>id</b>: gaps-organization-reportingvendor</p><p><b>meta</b>: </p><p><b>identifier</b>: Tax ID number = 123446789 (OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type pay}\">Payer</span></p><p><b>name</b>: GapsReportingVendor01</p><p><b>telecom</b>: ph: (+1) 401-545-1212</p><p><b>address</b>: 13 Drive Street Cityplace MA 01101 USA </p></div>"
},
"identifier": [
{
"use": "official",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "TAX",
"display": "Tax ID number"
}
]
},
"system": "urn:oid:2.16.840.1.113883.4.4",
"value": "123446789",
"assigner": {
"display": "www.irs.gov"
}
}
],
"active": true,
"type": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/organization-type",
"code": "pay",
"display": "Payer"
}
]
}
],
"name": "GapsReportingVendor01",
"telecom": [
{
"system": "phone",
"value": "(+1) 401-545-1212"
}
],
"address": [
{
"line": [
"13 Drive Street"
],
"city": "Cityplace",
"state": "MA",
"postalCode": "01101",
"country": "USA"
}
]
}
}
]
}
}
]
}
IG © 2020+ HL7 International - Clinical Quality Information Work Group. Package hl7.fhir.us.davinci-deqm#2.1.0 based on FHIR 4.0.1. Generated 2020-08-15
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