HL7.FHIR.US.DAVINCI-DEQM\Summary Reporting

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

Summary Reporting

Introduction
Default Profiles
Summary Measure Reporting

ONLY the new content for Gaps in Care is in the scope for ballot for the September, 2020 Ballot Cycle. Summary Reporting is not in scope for ballot comment.

Introduction

A summary report contains calculated summary data for one or more Clinical Quality Measures (CQMs) for a specified population of patients within a particular health system over a specific period of time. For example, a colorectal cancer screening CQM has patient counts for the initial population, denominator, denominator exclusions, and numerator respectively for a specified population of patients. Summary reports may also contain summary data for stratifier criteria (such as gender or age) as defined in a CQM.

The Summary reporting scenario is supported by the DEQM Summary MeasureReport Profile. Transactions between Reporters (for example, organizations that deliver care to patients, such as a practice or hospital) and Receivers (organizations that want to evaluate CQMs, such as quality reporting programs) are triggered by specific administrative events such as the submission of summary level quality reports for CQMs to various quality reporting programs.

Default Profiles

The following resources are used in the summary reporting scenario:

Resource Type	Profile Name	Link to Profile
Measure	CQFM Measure Profile	CQFM Measure
Summary MeasureReport	DEQM Summary MeasureReport Profile	DEQM Summary MeasureReport Profile
Organization	DEQM Organization Profile	DEQM Organization

Summary Measure Reporting

When the results of a quality measure are completed for a population at the end of a measurement period, they are POSTed to the quality measure Receiver’s FHIR Server. The report may only consist of the Summary MeasureReport in which case it is POSTed to the MeasureReport endpoint. If there are other referenced resources all the resources are bundled together as a set of POST interactions and sent as a single transaction interaction using the Standard FHIR API. Multiple summary results can be sent in a single FHIR Bundle as described here. (Note that if the Bundle consist of only Summary MeasureReports, then a collection bundle is used.)

Posting a Summary Measure Report is typically a one time event, although there may be a need to amend or update a report or to report periodically based on the reporting program. If the payload is a single Summary MeasureReport it is updated using the PUT or Delete transactions. Otherwise, the FHIR transaction bundle is used and SHALL contains only the new and updated DEQM and QI Core Profiles since the last transaction or those that need to be deleted. (Bundle.request.method = POST, PUT, or DELETE).

Usage

for a single MeasureReport:

POST|[base]/MeasureReport

for a Bundle Transaction:

POST|[base]

Standard error responses to the Summary Reporting FHIR RESTful transactions including appropriate http response codes are documented in the FHIR specification for RESTful API.

Examples

Scenario:

Payer X who is acting in the role of a Reporter submits a MRP Summary Report for MRP for period P to Receiver Z. The body of the request is MeasureReport resource containing the required summary data for MRP attestation for the period. (Note that this a simplified example and just populates the count for initial population. However, counts for all populations specified in an eCQM should be reported in a summary report) An HTTP Status success code is returned on successful submission.

POST Summary Report

POST [base]/MeasureReport

Request body

{
  "resourceType": "MeasureReport",
  "id": "summ-measurereport01",
  "meta": {
    "source": "http://example.org/fhir/server",
    "profile": [
      "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/summary-measurereport-deqm"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>id</b>: summ-measurereport01</p><p><b>meta</b>: </p><p><b>status</b>: complete</p><p><b>type</b>: summary</p><p><b>measure</b>: <a href=\"http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example\">http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example</a></p><p><b>date</b>: 06/09/2018 2:59:52 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>: 2018-08-01 --&gt; 2018-09-01</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>code</b>: <span title=\"Codes: {http://example.org mrp-group}\">MRP Group</span></p><blockquote><p><b>population</b></p><p><b>id</b>: initial-population</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>: 100</p></blockquote><blockquote><p><b>population</b></p><p><b>id</b>: numerator</p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population numerator}\">Numerator</span></p><p><b>count</b>: 80</p></blockquote><blockquote><p><b>population</b></p><p><b>id</b>: denominator</p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population denominator}\">Denominator</span></p><p><b>count</b>: 100</p></blockquote><p><b>measureScore</b>: 0.8</p></blockquote></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"
          }
        ]
      }
    }
  ],
  "status": "complete",
  "type": "summary",
  "measure": "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
  "date": "2018-09-05T16:59:52.404Z",
  "reporter": {
    "extension": [
      {
        "url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-reporterGroup",
        "valueReference": {
          "reference": "Group/group01"
        }
      }
    ],
    "reference": "Organization/organization01"
  },
  "period": {
    "start": "2018-08-01",
    "end": "2018-09-01"
  },
  "improvementNotation": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
        "code": "increase",
        "display": "Increased score indicates improvement"
      }
    ]
  },
  "group": [
    {
      "code": {
        "coding": [
          {
            "system": "http://example.org",
            "code": "mrp-group",
            "display": "MRP Group"
          }
        ],
        "text": "MRP Group"
      },
      "population": [
        {
          "id": "initial-population",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "initial-population",
                "display": "Initial Population"
              }
            ]
          },
          "count": 100
        },
        {
          "id": "numerator",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "numerator",
                "display": "Numerator"
              }
            ]
          },
          "count": 80
        },
        {
          "id": "denominator",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "denominator",
                "display": "Denominator"
              }
            ]
          },
          "count": 100
        }
      ],
      "measureScore": {
        "value": 0.8
      }
    }
  ]
}

Response

HTTP/1.1 200 OK
[other headers]

for an example of a Summary MeasureReport with counts for multiple populations and stratifiers specified in an eCQM see the Medicare Stratification Example. For an example of a Bundle of multiple summary results see the Bundle Multiple Summ Report.