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

: Mrp Submit Obs - XML Representation

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<Parameters xmlns="http://hl7.org/fhir">
  <id value="mrp-submit-obs"/>
  <meta>
    <source value="http://example.org/fhir/server"/>
  </meta>
  <parameter>
    <name value="measureReport"/>
    <resource>
      <MeasureReport>
        <id value="datax-measurereport02"/>
        <meta>
          <versionId value="1"/>
          <lastUpdated value="2018-09-05T16:59:53.000+00:00"/>
          <source value="http://example.org/fhir/server"/>
          <profile
                   value="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/datax-measurereport-deqm"/>
        </meta>
        <extension
                   url="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-submitDataUpdateType">
          <valueCode value="incremental"/>
        </extension>
        <status value="complete"/>
        <type value="data-collection"/>
        <measure
                 value="http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example"/>
        <subject>
          <reference value="Patient/patient02"/>
        </subject>
        <date value="2018-09-05T16:59:52.404Z"/>
        <reporter>
          <reference value="Organization/organization01"/>
        </reporter>
        <period>
          <start value="2018-08-01"/>
          <end value="2018-09-01"/>
        </period>
        <evaluatedResource>
          <reference value="Observation/observation01"/>
        </evaluatedResource>
      </MeasureReport>
    </resource>
  </parameter>
  <parameter>
    <name value="resource"/>
    <resource>
      <Patient>
        <id value="patient01"/>
        <meta>
          <versionId value="5"/>
          <lastUpdated value="2019-02-11T14:19:25.000+00:00"/>
          <source value="http://example.org/fhir/server"/>
          <profile
                   value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><div class="hapiHeaderText">Jairo <b>WEBSTER </b></div><table class="hapiPropertyTable"><tbody><tr><td>Identifier</td><td>12345</td></tr><tr><td>Address</td><td><span>7496 Beaver Ridge Ave </span><br/><span>Thornton </span><span>NJ </span><span>USA </span></td></tr><tr><td>Date of birth</td><td><span>16 December 1946</span></td></tr></tbody></table></div>
        </text>
        <extension
                   url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex">
          <valueCode value="M"/>
        </extension>
        <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="2106-3"/>
              <display value="White"/>
            </valueCoding>
          </extension>
          <extension url="text">
            <valueString value="White"/>
          </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="2186-5"/>
              <display value="Not Hispanic or Latino"/>
            </valueCoding>
          </extension>
          <extension url="text">
            <valueString value="Not 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.davinci.org"/>
          <value value="12345"/>
        </identifier>
        <active value="true"/>
        <name>
          <use value="official"/>
          <family value="Webster"/>
          <given value="Jairo"/>
        </name>
        <gender value="male"/>
        <birthDate value="1946-12-16"/>
        <deceasedBoolean value="false"/>
        <address>
          <use value="home"/>
          <line value="7496 Beaver Ridge Ave"/>
          <city value="Thornton"/>
          <state value="NJ"/>
          <postalCode value="07003"/>
          <country value="USA"/>
        </address>
        <maritalStatus>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/v3-MaritalStatus"/>
            <code value="M"/>
            <display value="Married"/>
          </coding>
        </maritalStatus>
        <communication>
          <language>
            <coding>
              <system value="urn:ietf:bcp:47"/>
              <code value="en-US"/>
              <display value="English (Region=United States)"/>
            </coding>
          </language>
          <preferred value="true"/>
        </communication>
        <managingOrganization>
          <reference value="Organization/organization01"/>
        </managingOrganization>
      </Patient>
    </resource>
  </parameter>
  <parameter>
    <name value="resource"/>
    <resource>
      <Observation>
        <id value="observation01"/>
        <meta>
          <source value="http://example.org/fhir/server"/>
          <profile
                   value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"/>
        </meta>
        <status value="final"/>
        <category>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/observation-category"/>
            <code value="exam"/>
            <display value="Exam"/>
          </coding>
        </category>
        <code>
          <coding>
            <system value="http://www.ama-assn.org/go/cpt"/>
            <code value="1111F"/>
            <display
                     value="Discharge medications reconciled with the current medication list in outpatient medical record (COA) (GER)"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/patient01"/>
        </subject>
        <encounter>
          <reference value="Encounter/encounter01"/>
        </encounter>
        <effectiveDateTime value="2018-09-29T14:15:04.424Z"/>
        <issued value="2018-09-29T14:15:04.424Z"/>
        <performer>
          <reference value="Practitioner/practitioner01"/>
        </performer>
        <valueBoolean value="true"/>
      </Observation>
    </resource>
  </parameter>
  <parameter>
    <name value="resource"/>
    <resource>
      <Practitioner>
        <id value="practitioner01"/>
        <meta>
          <source value="http://example.org/fhir/server"/>
          <profile
                   value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"/>
        </meta>
        <identifier>
          <use value="official"/>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="PRN"/>
              <display value="Provider number"/>
            </coding>
          </type>
          <system value="http://hl7.org/fhir/sid/us-npi"/>
          <value value="456789123"/>
        </identifier>
        <active value="true"/>
        <name>
          <family value="Hale"/>
          <given value="Cody"/>
          <suffix value="MD"/>
        </name>
        <gender value="male"/>
      </Practitioner>
    </resource>
  </parameter>
  <parameter>
    <name value="resource"/>
    <resource>
      <Encounter>
        <id value="encounter01"/>
        <meta>
          <source value="http://example.org/fhir/server"/>
          <profile
                   value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        </meta>
        <status value="finished"/>
        <class>
          <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
          <code value="IMP"/>
          <display value="inpatient encounter"/>
        </class>
        <type>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="56876005"/>
            <display value="Drug rehabilitation and detoxification"/>
          </coding>
        </type>
        <subject>
          <reference value="Patient/patient01"/>
          <display value="Jairo Webster"/>
        </subject>
        <period>
          <start value="2018-05-29T11:00:00-04:00"/>
          <end value="2018-05-29T11:00:00-04:00"/>
        </period>
        <hospitalization>
          <dischargeDisposition>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/discharge-disposition"/>
              <code value="home"/>
              <display value="Home"/>
            </coding>
          </dischargeDisposition>
        </hospitalization>
      </Encounter>
    </resource>
  </parameter>
  <parameter>
    <name value="resource"/>
    <resource>
      <Coverage>
        <id value="coverage01"/>
        <meta>
          <versionId value="2"/>
          <lastUpdated value="2019-02-11T14:19:25.000+00:00"/>
          <source value="http://example.org/fhir/server"/>
          <profile
                   value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"/>
        </meta>
        <status value="active"/>
        <policyHolder>
          <reference value="Patient/patient01"/>
        </policyHolder>
        <subscriber>
          <reference value="Patient/patient01"/>
        </subscriber>
        <subscriberId value="A123456789"/>
        <beneficiary>
          <reference value="Patient/patient01"/>
        </beneficiary>
        <relationship>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
            <code value="self"/>
          </coding>
        </relationship>
        <payor>
          <reference value="Organization/organization04"/>
        </payor>
      </Coverage>
    </resource>
  </parameter>
  <parameter>
    <name value="resource"/>
    <resource>
      <Location>
        <id value="location01"/>
        <meta>
          <source value="http://example.org/fhir/server"/>
          <profile
                   value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location"/>
        </meta>
        <identifier>
          <use value="temp"/>
          <system value="http://exampleoflocation.com"/>
          <value value="DaVinciClinic01"/>
        </identifier>
        <name value="DaVinciClinic01"/>
        <address>
          <line value="102 Heritage Dr."/>
          <city value="Somerset"/>
          <state value="NJ"/>
          <postalCode value="08873"/>
          <country value="USA"/>
        </address>
      </Location>
    </resource>
  </parameter>
  <parameter>
    <name value="resource"/>
    <resource>
      <Organization>
        <id value="organization01"/>
        <meta>
          <versionId value="4"/>
          <lastUpdated value="2019-02-21T01:47:54.000+00:00"/>
          <source value="http://example.org/fhir/server"/>
          <profile
                   value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"/>
        </meta>
        <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="123456789"/>
          <assigner>
            <display value="www.irs.gov"/>
          </assigner>
        </identifier>
        <active value="true"/>
        <type>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/organization-type"/>
            <code value="prov"/>
            <display value="Healthcare Provider"/>
          </coding>
        </type>
        <name value="DaVinciHospital01"/>
        <telecom>
          <system value="phone"/>
          <value value="(+1) 401-555-1212"/>
        </telecom>
        <address>
          <line value="73 Lakewood Street"/>
          <city value="Warwick"/>
          <state value="RI"/>
          <postalCode value="02886"/>
          <country value="USA"/>
        </address>
      </Organization>
    </resource>
  </parameter>
  <parameter>
    <name value="resource"/>
    <resource>
      <Organization>
        <id value="organization02"/>
        <meta>
          <versionId value="3"/>
          <lastUpdated value="2019-03-06T19:03:03.000+00:00"/>
          <source value="http://example.org/fhir/server"/>
          <profile
                   value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"/>
        </meta>
        <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="234567891"/>
          <assigner>
            <display value="www.irs.gov"/>
          </assigner>
        </identifier>
        <active value="true"/>
        <type>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/organization-type"/>
            <code value="prov"/>
            <display value="Healthcare Provider"/>
          </coding>
        </type>
        <name value="DaVinciHospital02"/>
        <telecom>
          <system value="phone"/>
          <value value="(+1) 551-555-1212"/>
        </telecom>
        <address>
          <line value="3 Sherwood St."/>
          <city value="Englewood"/>
          <state value="NJ"/>
          <postalCode value="07631"/>
          <country value="USA"/>
        </address>
      </Organization>
    </resource>
  </parameter>
  <parameter>
    <name value="resource"/>
    <resource>
      <Organization>
        <id value="organization04"/>
        <meta>
          <versionId value="4"/>
          <lastUpdated value="2019-03-06T19:03:03.000+00:00"/>
          <source value="http://example.org/fhir/server"/>
          <profile
                   value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"/>
        </meta>
        <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="456789123"/>
          <assigner>
            <display value="www.irs.gov"/>
          </assigner>
        </identifier>
        <active value="true"/>
        <type>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/organization-type"/>
            <code value="ins"/>
            <display value="Insurance Company"/>
          </coding>
        </type>
        <name value="DVPayer04"/>
        <telecom>
          <system value="phone"/>
          <value value="(+1) 616-555-1212"/>
        </telecom>
        <address>
          <line value="160 Glen Eagles Road"/>
          <city value="Grand Rapids"/>
          <state value="MI"/>
          <postalCode value="49503"/>
          <country value="USA"/>
        </address>
      </Organization>
    </resource>
  </parameter>
</Parameters>