This page is part of the Da Vinci Data Exchange for Quality Measures (DEQM) FHIR IG (v1.0.0: STU 1) based on FHIR R3. The current version which supercedes this version is 3.1.0. For a full list of available versions, see the Directory of published versions 
Colorectal Cancer Screening Use Case
- Introduction
- FHIR Resource Overview
- Graph of COL Resources
- COL Data Exchange Interactions
- COL Measure Reporting Interactions
Introduction
The colonoscopy measure such as HEDIS Colorectal Cancer Screening/CMS1301 is an example of a process measure evaluating screenings for preventive health services. Screening measures assess the number of eligible persons receiving clinical guideline recommended screening for all patients in the population receiving care during the measurement period.
COL Use Case Background
In the case of colorectal cancer screening, two types of data are reported: 1) testing to detect colorectal cancer and polyps and 2) information that would exclude the patient from needing testing. For background on the clinical guideline that the measure was built off of see the Colorectal Cancer Screening Recommendation Statement published by the Electronic Clinical Quality Improvement (eCQI) Resource Center.
FHIR Resource Overview
Resources Supported for this Use Case
| Resource Type | Profile Name | Link to Profile |
|---|---|---|
| Condition | QI Core Condition Profile | QI Core Condition |
| Coverage | QI Core Coverage Profile | QI Core Coverage |
| DiagnosticReport | QI Core DiagnosticReport Profile | QI Core DiagnosticReport |
| Encounter | QI Core Encounter Profile | QI Core Encounter |
| Library | CQFM Library Profile | CQFM Library |
| Location | QI Core Location Profile | QI Core Location |
| Measure | CQFM Measure Profile | CQFM Measure |
| MeasureReport | DEQM Data Exchange MeasureReport Profile | DEQM Data Exchange MeasureReport Profile |
| MeasureReport | DEQM Individual MeasureReport Profile | DEQM Individual MeasureReport Profile |
| MeasureReport | DEQM Summary MeasureReport Profile | DEQM Summary MeasureReport Profile |
| Observation | QI Core Observation Profile | QI Core Observation |
| 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 |
Graph of COL Resources
For COL either an Observation, DiagnosticReport, Condition, or Procedure is the primary resource used to evaluate the measure. Below are listed the resource diagrams that meet each situation in the COL screening measure. Note that overlapping boxes in the diagrams represents a choice of one or the resources.
Option 1: MeasureReport Using Observation
When certain laboratory results such as fecal occult blood (FOBT) and FIT-DNA are done in a specified time period, the patient has been screened for colorectal cancer. The valueset binding (i.e., list of codes) in the measure will inform you as to which laboratory results qualify for meeting this measure. The following resource graph diagram shows how a laboratory test to meet the screen measure would be represented using a DEQM Individual MeasureReport and its associated resources.
Option 2: MeasureReport Using DiagnosticReport
Another way a COL screening measure is met is when certain procedures such as flexible sigmoidoscopy and colonoscopy are performed and a report generated. In FHIR, the report is represented by a DiagnosticReport. The measure indicates what ValueSets/Codes can be used to report this measure. The following diagram shows how a procedure report to meet a screening measure would be represented in a DEQM Individual MeasureReport and its associated resources.
Option 3: MeasureReport Using Procedure
There are often times exclusions in a screening measure. An exclusion is something that removes the requirement for a screening measure. For example, a total colectomy removes the requirement for Colorectal Cancer Screening. As with the other options, the measure defines the valueset/codes that constitute a qualifying procedure. The following diagram shows how you would use a DEQM Individual MeasureReport and its associated resources to report a procedure that represents an exclusion to the measure.
Option 4: MeasureReport Using Condition
An additional way exclusions are met in the Colorectal Cancer Screening measure is with certain conditions such as colorectal cancer. The valuesets/codes that allow for the patient not to be screened for colorectal cancer are specified in the measure. The following MeasureReport diagram shows how you would use a DEQM Individual MeasureReport and its associated resources to represent a condition that represents an exclusion to the measure.
COL Data Exchange Interactions
In the following interactions, the Provider is acting in the role of the Producer and the Payer (“Aggregator”) is acting in the role of the Consumer.
Gather Data Requirements from Payer
In this optional step, the Provider queries the Payer (“Aggregator”) for which resources are needed for COL measure reporting. Note that instead of using this API, the measure definition can be reviewed manually to determine what data needs to be submitted.
Scenario
Provider X acting in the role of the Producer requests data requirements for the COL measure from Payer Z which is acting in the role of Consumer. A Library resource containing the required resources for COL attestation returned on successful evaluation.
Request using GET
GET [base]/Measure/measure-col/$data-requirements?periodStart=2018-01-01&periodEnd=2018-12-31
Request using POST
POST [base]/Measure/measure-col/$data-requirements
Request body
{
"resourceType":"Parameters",
"parameter":[
{
"name":"periodStart",
"valueDate":"2018-01-01"
},
{
"name":"periodEnd",
"valueDate":"2018-12-31"
}
]
}
Response
HTTP/1.1 200 OK
[other headers]
Response body
{
"resourceType":"Library",
"status":"active",
"type":{
"coding":[
{
"code":"module-definition"
}
]
},
"relatedArtifact":[
{
"type":"depends-on",
"resource":{
"reference":"http://hl7.org/fhir/us/hedis/Library/library-col-logic"
}
}
],
"dataRequirement": [
{
"type": "Observation",
"profile":[
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"
],
"codeFilter": [
{
"path": "code",
"valueSetString": "urn:oid:2.16.840.1.113883.3.464.1004.1093"
},
{
"path": "status",
"valueCode": [
"final",
"amended"
]
}
]
},
{
"type": "DiagnosticReport",
"profile":[
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-diagnosticreport"
],
"codeFilter": [
{
"path": "code",
"valueSetString": "urn:oid:2.16.840.1.113883.3.464.1004.1102"
},
{
"path": "status",
"valueCode": [
"preliminary",
"final",
"amended",
"corrected",
"appended"
]
}
]
},
{
"type": "DiagnosticReport",
"profile":[
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-diagnosticreport"
],
"codeFilter": [
{
"path": "code",
"valueSetString": "urn:oid:2.16.840.1.113883.3.464.1004.1064"
},
{
"path": "status",
"valueCode": [
"preliminary",
"final",
"amended",
"corrected",
"appended"
]
}
]
},
{
"type": "DiagnosticReport",
"profile":[
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-diagnosticreport"
],
"codeFilter": [
{
"path": "code",
"valueSetString": "urn:oid:2.16.840.1.113883.3.464.1004.1421"
},
{
"path": "status",
"valueCode": [
"preliminary",
"final",
"amended",
"corrected",
"appended"
]
}
]
},
{
"type": "Observation",
"profile":[
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"
],
"codeFilter": [
{
"path": "code",
"valueSetString": "urn:oid:2.16.840.1.113883.3.464.1004.1420"
},
{
"path": "status",
"valueCode": [
"final",
"amended"
]
}
]
},
{
"type": "Condition",
"profile":[
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition"
],
"codeFilter": [
{
"path": "code",
"valueSetString": "urn:oid:2.16.840.1.113883.3.464.1004.1065"
},
{
"path": "verificationStatus",
"valueCode": [
"confirmed"
]
}
]
},
{
"type": "Procedure",
"profile":[
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"
],
"codeFilter": [
{
"path": "code",
"valueSetString": "urn:oid:2.16.840.1.113883.3.464.1004.1250"
},
{
"path": "status",
"valueCode": [
"completed"
]
}
]
},
{
"type": "Patient",
"profile":[
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
]
}
]
}
Exchange of Quality Measure Data Options
We are seeking input on the feasibility and interest in using CDS Hooks to report on Screening data.
Data Exchange Using the Submit Data Operation
The Provider will use the Submit Data operation to submit a MeasureReport and the referenced resources required by the payers as supporting evidence for Colorectal Cancer Screening to the payer.
Examples
Scenario:
Provider X acting in the role of Producer submits COL data for Patient Y to Payer Z who is acting in the role of Consumer. The body of the request is a Parameters resource containing the required profiles for COL attestation. An HTTP Status success code is returned on successful submission.
Request using POST
POST [base]/Measure/measure-col/$submit-data
Request body
{
"resourceType": "Parameters",
"parameter": [
{
"name": "measure-report",
"resource": {
"resourceType": "MeasureReport",
"id": "col-measurereport",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/datax-measurereport-deqm"
]
},
"status": "complete",
"_type": {
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-dataCollectionType",
"valueBoolean": true
}
]
},
"measure": {
"reference": "Measure/measure-col"
},
"patient": {
"reference": "Patient/patient-col"
},
"date": "2019-01-01T16:59:52.404Z",
"period": {
"start": "2018-01-01",
"end": "2018-12-31"
}
}
},
{
"name": "resource",
"resource": {
"resourceType": "Observation",
"id": "fit-dna-observation",
"meta": {
"profile": [
"http://hl7.org/fhir/us/hedis/StructureDefinition/hedis-observation"
]
},
"status": "final",
"category": [
{
"system": "http://hl7.org/fhir/observation-category",
"code": "laboratory",
"display": "Laboratory"
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "77353-1",
"display": "Noninvasive colorectal cancer DNA and occult blood screening [Interpretation] in Stool Narrative"
}
]
},
"subject": {
"reference": "Patient/patient-col"
},
"effectiveDateTime": "2018-06-22",
"performer": [
{
"reference": "Practitioner/practitioner-col"
}
]
}
},
{
"name": "resource",
"resource": {
"resourceType": "Patient",
"id": "patient-col",
"meta": {
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
]
},
"extension": [
{
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
"valueCode": "F"
},
{
"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": "2106-3",
"display": "White"
}
},
{
"url": "text",
"valueString": "White"
}
]
},
{
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity",
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2186-5",
"display": "Not Hispanic or Latino"
}
},
{
"url": "text",
"valueString": "Not Hispanic or Latino"
}
]
}
],
"identifier": [
{
"use": "usual",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/v2/0203",
"code": "MR",
"display": "Medical record number"
}
]
},
"system": "http://hospital.davinci.org",
"value": "67890"
}
],
"active": true,
"name": [
{
"use": "official",
"family": "Webster",
"given": [
"Thelma"
]
}
],
"gender": "female",
"birthDate": "1948-04-28",
"deceasedBoolean": false,
"address": [
{
"use": "home",
"line": [
"7496 Beaver Ridge Ave"
],
"city": "Thornton",
"state": "NJ",
"postalCode": "07003",
"country": "USA"
}
],
"maritalStatus": {
"coding": [
{
"system": "http://hl7.org/fhir/v3/MaritalStatus",
"code": "M",
"display": "Married"
}
]
},
"communication": [
{
"language": {
"coding": [
{
"system": "urn:ietf:bcp:47",
"code": "en-US",
"display": "US English"
}
]
},
"preferred": true
}
]
}
},
{
"name": "resource",
"resource": {
"resourceType": "Practitioner",
"id": "practitioner-col",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/practitioner-deqm"
]
},
"identifier": [
{
"use": "official",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/v2/0203",
"code": "PRN",
"display": "Provider number"
}
]
},
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "123456789"
}
],
"active": true,
"name": [
{
"family": "Akers",
"given": [
"Nia"
],
"suffix": [
"MD"
]
}
],
"gender": "female"
}
}
]
}
Response
HTTP/1.1 200 OK
[other headers]
Data Exchange Using the Collect Data Operation
Payer/Aggregator retrieves Colorectal Cancer Screening Data from Provider using the Collect Data operation. The Provider returns the MeasureReport and referenced resources as supporting evidence for Colorectal Cancer Screening.
Examples
Scenario:
Payer X acting in the role of Consumer collect Patient Y’s COL data from Provider Z, which is acting in the role of Producer. The body of the request is a Parameters resource containing the desired input parameters. An HTTP Status success code is returned on successful submission.
Request using POST
POST [base]/Measure/measure-col/$collect-data
Request body
{
"resourceType": "Parameters",
"parameter": [
{
"name": "periodStart",
"valueDate": "2018-01-01"
},
{
"name": "periodEnd",
"valueDate": "2018-12-31"
},
{
"name": "patient",
"valueUri": "Patient/patient-col"
}
]
}
Response
HTTP/1.1 200
Date: Wed, 14 Mar 2019 01:02:06 GMT
Content-Type: application/fhir+json;charset=UTF-8
...Other Headers...
{
"resourceType": "Parameters",
"parameter": [
{
"name": "measurereport",
"resource": {
"resourceType": "MeasureReport",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/datax-measurereport-deqm"
]
},
"status": "complete",
"_type": {
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-dataCollectionType",
"valueBoolean": true
}
]
},
"measure": "Measure/measure-col",
"patient": {
"reference": Patient/patient-col
},
"date": "2019-03-14",
"period": {
"start": "2018-01-01,
"end": "2018-12-31"
},
"evaluatedResources": {
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-referenceAny",
"valueReference": {
"reference": "Patient/patient-col"
}
},
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-referenceAny",
"valueReference": {
"reference": "Practitioner/practitioner-col"
}
},
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-referenceAny",
"valueReference": {
"reference": "Observation/fit-dna-observation"
}
}
]
}
}
},
{
"name": "resource",
"resource": {
"resourceType": "Patient",
"id": "patient-col",
"meta": {
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
]
},
"extension": [
{
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
"valueCode": "F"
},
{
"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": "2106-3",
"display": "White"
}
},
{
"url": "text",
"valueString": "White"
}
]
},
{
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity",
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2186-5",
"display": "Not Hispanic or Latino"
}
},
{
"url": "text",
"valueString": "Not Hispanic or Latino"
}
]
}
],
"identifier": [
{
"use": "usual",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/v2/0203",
"code": "MR",
"display": "Medical record number"
}
]
},
"system": "http://hospital.davinci.org",
"value": "67890"
}
],
"active": true,
"name": [
{
"use": "official",
"family": "Webster",
"given": [
"Thelma"
]
}
],
"gender": "female",
"birthDate": "1948-04-28",
"deceasedBoolean": false,
"address": [
{
"use": "home",
"line": [
"7496 Beaver Ridge Ave"
],
"city": "Thornton",
"state": "NJ",
"postalCode": "07003",
"country": "USA"
}
],
"maritalStatus": {
"coding": [
{
"system": "http://hl7.org/fhir/v3/MaritalStatus",
"code": "M",
"display": "Married"
}
]
},
"communication": [
{
"language": {
"coding": [
{
"system": "urn:ietf:bcp:47",
"code": "en-US",
"display": "US English"
}
]
},
"preferred": true
}
]
}
},
{
"name": "resource",
"resource": {
"resourceType": "Practitioner",
"id": "practitioner-col",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/practitioner-deqm"
]
},
"identifier": [
{
"use": "official",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/v2/0203",
"code": "PRN",
"display": "Provider number"
}
]
},
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "123456789"
}
],
"active": true,
"name": [
{
"family": "Akers",
"given": [
"Nia"
],
"suffix": [
"MD"
]
}
],
"gender": "female"
}
},
{
"name": "resource",
"resource": {
"resourceType": "Observation",
"id": "fit-dna-observation",
"meta": {
"profile": [
"http://hl7.org/fhir/us/hedis/StructureDefinition/hedis-observation"
]
},
"status": "final",
"category": [
{
"system": "http://hl7.org/fhir/observation-category",
"code": "laboratory",
"display": "Laboratory"
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "77353-1",
"display": "Noninvasive colorectal cancer DNA and occult blood screening [Interpretation] in Stool Narrative"
}
]
},
"subject": {
"reference": "Patient/patient-col"
},
"effectiveDateTime": "2018-06-22",
"performer": [
{
"reference": "Practitioner/practitioner-col"
}
]
}
}
]
}
COL Measure Reporting Interactions
In the following interactions, The Payer (“Aggregator”) is acting in the role of the Reporter.
Individual MeasureReport
Payer in the role of the Reporter pushes the Bundle of supporting resource with COL Individual MeasureReport resource to the end user.
Examples
Scenario:
Payer X who is acting in the role of a Reporter submits a COL Individual Report for Patient P to Receiver Z. The body of the request is a transaction bundle including the Individual MeasureReport and all the related resources containing the relevant data used to compute the CQM criteria. An HTTP Status success code and transaction-response Bundle is returned on successful submission.
POST Individual Report
POST [base]
Request body
{
"resourceType": "Bundle",
"type": "transaction",
"entry": [
{
"fullUrl": "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57904",
"resource": {
"resourceType": "MeasureReport",
"status": "complete",
"type": "individual",
"measure": {
"reference": "Measure/measure-col"
},
"patient": {
"reference": "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57906"
},
"date": "2019-03-14",
"reportingOrganization": {
"reference": "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57905"
},
"period": {
"end": "2018-01-01",
"start": "2018-12-31"
},
"group": [
{
"population": [
{
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/measure-population",
"code": "initial-population",
"display": "Initial Population"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/measure-population",
"code": "numerator",
"display": "Numerator"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/measure-population",
"code": "denominator",
"display": "Denominator"
}
]
}
}
],
"measureScore": 100
}
]
},
"request": {
"method": "POST",
"url": "MeasureReport"
}
},
{
"fullUrl": "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57905",
"resource": {
"resourceType": "Organization",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
]
},
"identifier": [
{
"use": "official",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/v2/0203",
"code": "TAX",
"display": "Tax ID number"
}
]
},
"system": "urn:oid:2.16.840.1.113883.4.2",
"value": "123456789",
"assigner": {
"display": "www.irs.gov"
}
}
],
"active": true,
"type": [
{
"coding": [
{
"system": "http://hl7.org/fhir/organization-type",
"code": "prov",
"display": "Healthcare Provider"
}
]
}
],
"name": "DaVinciHospital01",
"telecom": [
{
"system": "phone",
"value": "(+1) 401-555-1212"
}
],
"address": [
{
"line": [
"73 Lakewood Street"
],
"city": "Warwick",
"state": "RI",
"postalCode": "02886",
"country": "USA"
}
]
},
"request": {
"method": "POST",
"url": "Organization"
}
},
{
"fullUrl": "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57906",
"resource": {
"resourceType": "Patient",
"meta": {
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
]
},
"extension": [
{
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
"valueCode": "F"
},
{
"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": "2106-3",
"display": "White"
}
},
{
"url": "text",
"valueString": "White"
}
]
},
{
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity",
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2186-5",
"display": "Not Hispanic or Latino"
}
},
{
"url": "text",
"valueString": "Not Hispanic or Latino"
}
]
}
],
"identifier": [
{
"use": "usual",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/v2/0203",
"code": "MR",
"display": "Medical record number"
}
]
},
"system": "http://hospital.davinci.org",
"value": "67890"
}
],
"active": true,
"name": [
{
"use": "official",
"family": "Webster",
"given": [
"Thelma"
]
}
],
"gender": "female",
"birthDate": "1948-04-28",
"deceasedBoolean": false,
"address": [
{
"use": "home",
"line": [
"7496 Beaver Ridge Ave"
],
"city": "Thornton",
"state": "NJ",
"postalCode": "07003",
"country": "USA"
}
],
"maritalStatus": {
"coding": [
{
"system": "http://hl7.org/fhir/v3/MaritalStatus",
"code": "M",
"display": "Married"
}
]
},
"communication": [
{
"language": {
"coding": [
{
"system": "urn:ietf:bcp:47",
"code": "en-US",
"display": "US English"
}
]
},
"preferred": true
}
]
},
"request": {
"method": "POST",
"url": "Patient"
}
},
{
"fullUrl": "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57907",
"resource": {
"resourceType": "Practitioner",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/practitioner-deqm"
]
},
"identifier": [
{
"use": "official",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/v2/0203",
"code": "PRN",
"display": "Provider number"
}
]
},
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "123456789"
}
],
"active": true,
"name": [
{
"family": "Akers",
"given": [
"Nia"
],
"suffix": [
"MD"
]
}
],
"gender": "female"
},
"request": {
"method": "POST",
"url": "Practitioner"
}
},
{
"fullUrl": "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57908",
"resource": {
"resourceType": "Observation",
"meta": {
"profile": [
"http://hl7.org/fhir/us/hedis/StructureDefinition/hedis-observation"
]
},
"status": "final",
"category": [
{
"system": "http://hl7.org/fhir/observation-category",
"code": "laboratory",
"display": "Laboratory"
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "77353-1",
"display": "Noninvasive colorectal cancer DNA and occult blood screening [Interpretation] in Stool Narrative"
}
]
},
"subject": {
"reference": "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57906"
},
"effectiveDateTime": "2018-06-22",
"performer": [
{
"reference": "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57907"
}
]
},
"request": {
"method": "POST",
"url": "Observation"
}
}
]
}
Response
HTTP/1.1 200
Date: Wed, 13 Mar 2019 01:02:06 GMT
Content-Type: application/fhir+json;charset=UTF-8
...Other Headers...
{
"resourceType": "Bundle",
"type": "transaction-response",
"entry": [
{
"response": {
"status": "201 Created",
"location": "MeasureReport/col-measurereport/_history/1",
"etag": "1",
"lastModified": "2019-03-13T01:02:05.901+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Observation/fit-dna-observation/_history/1",
"etag": "1",
"lastModified": "2019-03-13T01:02:05.932+00:00"
}
},
{
"response": {
"status": "200 OK",
"location": "Patient/patient-col/_history/1",
"etag": "1",
"lastModified": "2019-03-13T01:02:05.932+00:00"
}
},
{
"response": {
"status": "200 OK",
"location": "Practitioner/practitioner-col/_history/1",
"etag": "1",
"lastModified": "2019-03-13T01:02:05.932+00:00"
}
}
]
}
Summary MeasureReport
Payer in the role of the Reporter posts the COL Summary MeasureReport to the Receiver
Examples
Scenario:
Payer X who is acting in the role of a Reporter submits a COL Summary Report for COL for period P to Receiver Z. The body of the request is MeasureReport resource containing the required summary data for COL attestation for the period. An HTTP Status success code is returned on successful submission.
POST Summary Report
POST [base]/MeasureReport
Request body
{
"resourceType": "MeasureReport",
"meta": {
"profile": [
"http://hl7.org/fhir/ig/davinci/StructureDefinition/summary-measurereport-deqm"
]
},
"status": "complete",
"type": "summary",
"measure": {
"reference": "Measure/measure-col"
},
"date": "2019-03-14",
"period": {
"start": "2018-01-01",
"end": "2018-12-31"
},
"reportingOrganization": {
"reference": "Organization/organization01"
},
"group": [
{
"identifier": {
"system": "http://www.acme.org/groups",
"value": "123"
},
"population": [
{
"identifier": {
"system": "http://www.acme.org/populations",
"value": "456"
},
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/measure-population",
"code": "initial-population",
"display": "Initial Population"
}
]
},
"count": 100
},
{
"identifier": {
"system": "http://www.acme.org/populations",
"value": "789"
},
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/measure-population",
"code": "numerator",
"display": "Numerator"
}
]
},
"count": 50
},
{
"identifier": {
"system": "http://www.acme.org/populations",
"value": "987"
},
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/measure-population",
"code": "denominator",
"display": "Denominator"
}
]
},
"count": 100
}
],
"measureScore": 50
}
]
}
Response
HTTP/1.1 200 OK
[other headers]
-
HEDIS measures referenced are example content only for the purposes of working through standards. Organizations should not be using the HEDIS specified measures for the actual measurement. ↩
