Data Exchange For Quality Measures Implementation Guide
4.0.0 - STU4
United States of America
Data Exchange For Quality Measures Implementation Guide
4.0.0 - STU4
United States of America
This page is part of the Da Vinci Data Exchange for Quality Measures (DEQM) FHIR IG (v4.0.0: STU4 (v4.0.0)) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions
<Bundle xmlns="http://hl7.org/fhir">
<id value="single-gaps-closed-indv-report02"/>
<meta>
<profile
value="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-bundle-deqm"/>
</meta>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:e2eaf470-f7ca-453f-8fd7-232a07f1b63c"/>
</identifier>
<type value="document"/>
<timestamp value="2020-07-07T13:08:53+00:00"/>
<entry>
<fullUrl
value="http://example.org/fhir/gaps/Composition/gaps-composition03"/>
<resource>
<Composition>
<id value="gaps-composition03"/>
<meta>
<profile
value="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-composition-deqm"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Composition</b><a name="gaps-composition03"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Composition "gaps-composition03" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-gaps-composition-deqm.html">DEQM Gaps In Care Composition Profile</a></p></div><p><b>status</b>: final</p><p><b>type</b>: Gaps in care report <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#96315-7)</span></p><p><b>date</b>: 2020-07-07 13:08:53+0000</p><p><b>author</b>: <a href="#Organization_gaps-organization-reportingvendor">See above (Organization/gaps-organization-reportingvendor)</a></p><p><b>title</b>: Care Gap Report for patient gaps-patient01</p></div>
</text>
<status value="final"/>
<type>
<coding>
<system value="http://loinc.org"/>
<code value="96315-7"/>
<display value="Gaps in care report"/>
</coding>
</type>
<subject>
<reference value="Patient/gaps-patient01"/>
</subject>
<date value="2020-07-07T13:08:53+00:00"/>
<author>
<reference value="Organization/gaps-organization-reportingvendor"/>
</author>
<title value="Care Gap Report for patient gaps-patient01"/>
<section>
<title value="Colorectal Cancer Screening"/>
<focus>
<reference value="MeasureReport/gaps-indv-measurereport04"/>
</focus>
<entry>
<reference value="DetectedIssue/gaps-detectedissue04"/>
</entry>
</section>
</Composition>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/gaps/DetectedIssue/gaps-detectedissue04"/>
<resource>
<DetectedIssue>
<id value="gaps-detectedissue04"/>
<meta>
<profile
value="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-detectedissue-deqm"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: DetectedIssue</b><a name="gaps-detectedissue04"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource DetectedIssue "gaps-detectedissue04" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-gaps-detectedissue-deqm.html">DEQM Gaps In Care Detected Issue Profile</a></p></div><blockquote><p><b>modifierExtension[http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-gapStatus]</b></p></blockquote><p><b>status</b>: final</p><p><b>code</b>: Caregap <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.2.0/CodeSystem-v3-ActCode.html">ActCode</a>#CAREGAP)</span></p><p><b>patient</b>: <a href="#Patient_gaps-patient01">See above (Patient/gaps-patient01)</a></p><h3>Evidences</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Detail</b></td></tr><tr><td style="display: none">*</td><td><a href="#MeasureReport_gaps-indv-measurereport04">See above (MeasureReport/gaps-indv-measurereport04)</a></td></tr></table></div>
</text>
<modifierExtension
url="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-gapStatus">
<valueCodeableConcept>
<coding>
<system
value="http://hl7.org/fhir/us/davinci-deqm/CodeSystem/gaps-status"/>
<code value="open-gap"/>
</coding>
</valueCodeableConcept>
</modifierExtension>
<status value="final"/>
<code>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="CAREGAP"/>
<display value="Caregap"/>
</coding>
</code>
<patient>
<reference value="Patient/gaps-patient01"/>
</patient>
<evidence>
<detail>
<reference value="MeasureReport/gaps-indv-measurereport04"/>
</detail>
</evidence>
</DetectedIssue>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/gaps/MeasureReport/gaps-indv-measurereport04"/>
<resource>
<MeasureReport>
<id value="gaps-indv-measurereport04"/>
<meta>
<profile
value="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: MeasureReport</b><a name="gaps-indv-measurereport04"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource MeasureReport "gaps-indv-measurereport04" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-indv-measurereport-deqm.html">DEQM Individual MeasureReport Profile</a></p></div><p><b>DEQM Measure Scoring Extension</b>: Proportion <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.2.0/CodeSystem-measure-scoring.html">MeasureScoring</a>#proportion)</span></p><p><b>DEQM Certification Identifier Extension</b>: id: 0015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href="#Organization_gaps-organization-reportingvendor">See above (Organization/gaps-organization-reportingvendor)</a></p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href="Measure-measure-exm130-example.html">Colorectal Cancer Screening Measure</a></p><p><b>subject</b>: <a href="#Patient_gaps-patient01">See above (Patient/gaps-patient01)</a></p><p><b>date</b>: 2020-07-07 13:08:52+0000</p><p><b>reporter</b>: <a href="Organization-organization01.html">Organization/organization01</a> "DaVinciHospital01"</p><p><b>period</b>: 2020-01-01 --> 2020-12-31</p><p><b>improvementNotation</b>: Increased score indicates improvement <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.2.0/CodeSystem-measure-improvement-notation.html">MeasureImprovementNotation</a>#increase)</span></p><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-exm130</blockquote><blockquote><p><b>population</b></p><p><b>code</b>: Initial Population <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html">MeasurePopulationType</a>#initial-population)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: Numerator <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html">MeasurePopulationType</a>#numerator)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: Denominator <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html">MeasurePopulationType</a>#denominator)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: Denominator Exclusion <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html">MeasurePopulationType</a>#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">See above (Encounter/gaps-encounter03)</a></li><li><a href="#Patient_gaps-patient01">See above (Patient/gaps-patient01)</a></li><li><a href="#Procedure_gaps-procedure02">See above (Procedure/gaps-procedure02)</a></li></ul></div>
</text>
<extension
url="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-certificationIdentifier">
<valueIdentifier>
<system value="urn:oid:2.16.840.1.113883.3.2074.1"/>
<value value="0015HQN9BD3304E"/>
</valueIdentifier>
</extension>
<extension
url="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-reportingVendor">
<valueReference>
<reference
value="Organization/gaps-organization-reportingvendor"/>
</valueReference>
</extension>
<status value="complete"/>
<type value="individual"/>
<measure
value="http://hl7.org/fhir/us/davinci-deqm/Measure/measure-exm130-example"/>
<subject>
<reference value="Patient/gaps-patient01"/>
</subject>
<date value="2020-07-07T13:08:52+00:00"/>
<reporter>
<reference value="Organization/organization01"/>
</reporter>
<period>
<start value="2020-01-01"/>
<end value="2020-12-31"/>
</period>
<improvementNotation>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="increase"/>
</coding>
</improvementNotation>
<group id="group-exm130">
<population>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<count value="1"/>
</population>
<population>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<count value="1"/>
</population>
<population>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<count value="1"/>
</population>
<population>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exclusion"/>
<display value="Denominator Exclusion"/>
</coding>
</code>
<count value="0"/>
</population>
<measureScore>
<value value="1.0"/>
</measureScore>
</group>
<evaluatedResource>
<extension
url="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-criteriaReference">
<valueString value="initial-population"/>
</extension>
<extension
url="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-criteriaReference">
<valueString value="denominator"/>
</extension>
<reference value="Encounter/gaps-encounter03"/>
</evaluatedResource>
<evaluatedResource>
<extension
url="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-criteriaReference">
<valueString value="initial-population"/>
</extension>
<extension
url="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-criteriaReference">
<valueString value="denominator"/>
</extension>
<reference value="Patient/gaps-patient01"/>
</evaluatedResource>
<evaluatedResource>
<extension
url="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-criteriaReference">
<valueString value="numerator"/>
</extension>
<reference value="Procedure/gaps-procedure02"/>
</evaluatedResource>
</MeasureReport>
</resource>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/gaps/Encounter/gaps-encounter03"/>
<resource>
<Encounter>
<id value="gaps-encounter03"/>
<meta>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Encounter</b><a name="gaps-encounter03"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Encounter "gaps-encounter03" </p><p style="margin-bottom: 0px">Profile: <a href="http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-encounter.html">QICore Encounter</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: ambulatory (Details: http://terminology.hl7.org/CodeSystem/v3-ActCode code AMB = 'ambulatory', stated as 'ambulatory')</p><p><b>type</b>: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using time for code selection, 15-29 minutes of total time is spent on the date of the encounter. <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.2.0/CodeSystem-CPT.html">Current Procedural Terminology (CPT®)</a>#99202)</span></p><p><b>subject</b>: <a href="#Patient_gaps-patient01">See above (Patient/gaps-patient01)</a></p><p><b>period</b>: 2020-07-06 07:07:00+0000 --> 2020-07-06 10:11:00+0000</p></div>
</text>
<status value="finished"/>
<class>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="AMB"/>
<display value="ambulatory"/>
</class>
<type>
<coding>
<system value="http://www.ama-assn.org/go/cpt"/>
<code value="99202"/>
<display
value="Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using time for code selection, 15-29 minutes of total time is spent on the date of the encounter."/>
</coding>
</type>
<subject>
<reference value="Patient/gaps-patient01"/>
</subject>
<period>
<start value="2020-07-06T07:07:00-00:00"/>
<end value="2020-07-06T10:11:00-00:00"/>
</period>
</Encounter>
</resource>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/gaps/Procedure/gaps-procedure02"/>
<resource>
<Procedure>
<id value="gaps-procedure02"/>
<meta>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Procedure</b><a name="gaps-procedure02"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Procedure "gaps-procedure02" </p><p style="margin-bottom: 0px">Profile: <a href="http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-procedure.html">QICore Procedure</a></p></div><p><b>QICore Not Done Recorded</b>: 2020-07-06 09:00:00+0000</p><p><b>status</b>: completed</p><p><b>code</b>: Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.2.0/CodeSystem-CPT.html">Current Procedural Terminology (CPT®)</a>#45384)</span></p><p><b>subject</b>: <a href="#Patient_gaps-patient01">See above (Patient/gaps-patient01)</a></p><p><b>performed</b>: 2020-07-06 08:00:00+0000 --> 2020-07-06 09:00:00+0000</p></div>
</text>
<extension
url="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded">
<valueDateTime value="2020-07-06T09:00:00-00:00"/>
</extension>
<status value="completed"/>
<code>
<coding>
<system value="http://www.ama-assn.org/go/cpt"/>
<code value="45384"/>
<display
value="Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"/>
</coding>
</code>
<subject>
<reference value="Patient/gaps-patient01"/>
</subject>
<performedPeriod>
<start value="2020-07-06T08:00:00-00:00"/>
<end value="2020-07-06T09:00:00-00:00"/>
</performedPeriod>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/gaps/Patient/gaps-patient01"/>
<resource>
<Patient>
<id value="gaps-patient01"/>
<meta>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Patient</b><a name="gaps-patient01"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Patient "gaps-patient01" </p><p style="margin-bottom: 0px">Profile: <a href="http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-patient.html">QICore Patient</a></p></div><blockquote><p><b>US Core Race Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: Asian (Details: urn:oid:2.16.840.1.113883.6.238 code 2028-9 = '2028-9', stated as 'Asian')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Asian</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: Hispanic or Latino (Details: urn:oid:2.16.840.1.113883.6.238 code 2135-2 = '2135-2', stated as 'Hispanic or Latino')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Hispanic or Latino</p></blockquote><p><b>identifier</b>: Medical Record Number: 999995992 (use: USUAL)</p><p><b>name</b>: Parker Susan </p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1965-01-01</p></div>
</text>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2028-9"/>
<display value="Asian"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="Asian"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2135-2"/>
<display value="Hispanic or Latino"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="Hispanic or Latino"/>
</extension>
</extension>
<identifier>
<use value="usual"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MR"/>
<display value="Medical Record Number"/>
</coding>
</type>
<system value="http://hospital.smarthealthit.org"/>
<value value="999995992"/>
</identifier>
<name>
<family value="Susan"/>
<given value="Parker"/>
</name>
<gender value="female"/>
<birthDate value="1965-01-01"/>
</Patient>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/gaps/Organization/gaps-organization-reportingvendor"/>
<resource>
<Organization>
<id value="gaps-organization-reportingvendor"/>
<meta>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Organization</b><a name="gaps-organization-reportingvendor"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Organization "gaps-organization-reportingvendor" </p><p style="margin-bottom: 0px">Profile: <a href="http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html">QICore Organization</a></p></div><p><b>identifier</b>: Tax ID number: 123446789 (use: OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: Payer <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.2.0/CodeSystem-organization-type.html">Organization type</a>#pay)</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>
</text>
<identifier>
<use value="official"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="TAX"/>
<display value="Tax ID number"/>
</coding>
</type>
<system value="urn:oid:2.16.840.1.113883.4.4"/>
<value value="123446789"/>
<assigner>
<display value="www.irs.gov"/>
</assigner>
</identifier>
<active value="true"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/organization-type"/>
<code value="pay"/>
<display value="Payer"/>
</coding>
</type>
<name value="GapsReportingVendor01"/>
<telecom>
<system value="phone"/>
<value value="(+1) 401-545-1212"/>
</telecom>
<address>
<line value="13 Drive Street"/>
<city value="Cityplace"/>
<state value="MA"/>
<postalCode value="01101"/>
<country value="USA"/>
</address>
</Organization>
</resource>
</entry>
</Bundle>
IG © 2020+ HL7 International / Clinical Quality Information. Package hl7.fhir.us.davinci-deqm#4.0.0 based on FHIR 4.0.1. Generated 2023-10-03
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