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 
Medication Reconciliation Process
- Introduction
- MRP Use Case Background
- FHIR Resource Overview
- Graph of MRP Resources
- MRP Data Exchange Interactions
- MRP Measure Reporting Interactions
Introduction
The Medication Reconciliation Use Case defines the process by which the MRP Measure data can be exchanged between a provider acting in the role of the Producer to a Payer which is acting in the role of the Consumer. MRP Measure is an attestation that a medication reconciliation post-discharge was performed on a covered member. This use case covers both the request to send attestation information and the unsolicited submission of that data.
MRP Use Case Background
In the case of medication reconciliation after discharge from the hospital, the patient’s discharge medication(s) is compared with the medication(s) the patient was taking prior to hospitalization. This can avoid medication errors such as omissions, duplications, dosing errors or drug interactions, and should be done at every transition of care in which new medications are ordered or existing orders are rewritten. This attestation message is intended to be performed by the next provider where the patient returns for follow-up and can then be used by the payer to show compliance for the HEDIS measure Medication Reconciliation Post-Discharge. (Any necessary documentation will also be put in the record)
In the past, attestation to the reconciliation had been done by posting a CPT Category II code on a claim typically for a small monetary amount that was then denied by the payer and had to be written off by the provider. This is a cumbersome process and most providers are no longer doing this.
Proof of 30 day medication reconciliations is increasingly required for value based care incentives. Providers and care coordinators face the challenge of collecting accurate and complete patient medication records across care settings. Today’s manual and ad hoc processes are costly and will not scale. Payers and providers need common standards to share the data required to complete medication reconciliation at all transitions of care, for care management plans, and during medication changes. Vendors are actively leveraging FHIR resources to improve partner’s access to patient medication history by unlocking existing silos of this critical data from vendor systems, healthcare operations systems and provider EHRs.
Note that the exchange of the reconciled medication list, indication of conversations with the patient, and notification of discharge from inpatient systems are out of scope for this version of the use case.
FHIR Resource Overview
Resources supported for this Use Case
| Resource Type | Profile Name | Link to Profile |
|---|---|---|
| Coverage | QI Core Coverage Profile | QI Core Coverage |
| Encounter | QI Core Encounter Profile | QI Core Encounter |
| Location | QI Core Location Profile | QI Core Location |
| Library | CQFM Library Profile | CQFM Library |
| 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 Profile1 | DEQM Organization |
| Patient | QI Core Patient Profile | QI Core Patient |
| Practitioner | DEQM Practitioner Profile1 | DEQM Practitioner |
| Task | QI Core Task Profile | QI Core Task |
Graph of MRP Resources
For MRP either a Task resource or an Observation resource can be used as the primary resource for evaluating the measure. The Task resource is more appropriate to represent an administrative activity that can be performed and the state of completion of that activity tracked. In the case where systems do not support Task, Observation can be used to track the status of the process. The table below compares how the activity is represented
| Data element | Task | Observation |
|---|---|---|
| The activity | Task.code |
Observation.code |
| The state of completion | Task.status |
Observation.valueBoolean(= “true” for complete) + Observation.status |
MRP 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 MRP measure reporting. Note that instead of using this API, the measure definition can be reviewed manually to determine what data needs to be submitted.
Example
Scenario
Provider X acting in the role of the Producer requests data requirements for the MRP measure from Payer Z which is acting in the role of Consumer. A Library resource containing the required resources for MRP attestation returned on successful evaluation.
Request using GET
GET [base]/Measure/measure-mrp/$data-requirements?periodStart=2018&periodEnd=2018
Request using POST
POST [base]/Measure/measure-mrp/$data-requirements
Request body
{
"resourceType":"Parameters",
"parameter":[
{
"name":"periodStart",
"valueDate":"2018"
},
{
"name":"periodEnd",
"valueDate":"2018"
}
]
}
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-mrp-logic"
}
}
],
"dataRequirement":[
{
"type":"MeasureReport",
"profile":[
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/measurereport-deqm"
]
},
{
"type":"Patient",
"profile":[
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
]
},
{
"type":"Encounter",
"profile":[
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
]
},
{
"type":"Location",
"profile":[
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location"
]
},
{
"type":"Task",
"profile":[
"http://ncqa.org/fhir/us/hedis/StructureDefinition/hedis-task"
]
},
{
"type":"Organization",
"profile":[
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
]
},
{
"type":"Practitioner",
"profile":[
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/practitioner-deqm"
]
}
]
}
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 to provide the MRP attestation to the Payer. Note that the Collect Data and Subscription Operations are not supported for this use case.
The technical Workflow is outlined in the following figure. The parts outlined in orange are the actual FHIR transactions that are the focus of this Guide and are described in detail in the following sections:
Examples
Scenario:
Provider X acting in the role of Producer submits MRP 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 MRP attestation using Task as the resource used to evaluate the measure. An HTTP Status success code is returned on successful submission.
Request using POST
POST [base]/Measure/measure-mrp/$submit-data
Request body
{
"resourceType": "Parameters",
"id": "025ed5bb-a2e7-bf6f-0559-f37c14a0c79e",
"parameter": [
{
"name": "measure-report",
"resource": {
"resourceType": "MeasureReport",
"id": "datax-measurereport01",
"meta": {
"versionId": "1",
"lastUpdated": "2018-09-05T16:59:53.000+00:00",
"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-mrp"
},
"patient": {
"reference": "Patient/patient01"
},
"date": "2018-09-05T16:59:52.404Z",
"period": {
"start": "2018-08-01",
"end": "2018-09-01"
},
"evaluatedResources": {
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-referenceAny",
"valueReference": {
"reference": "Task/Task01"
}
}
]
}
},
{
"name": "resource",
"resource": {
"resourceType": "Task",
"meta": {
"profile": [
"http://ncqa.org/fhir/us/hedis/StructureDefinition/hedis-task"
]
},
"id": "Task01",
"identifier": [
{
"system": "http://www.acme.org/tasks",
"value": "12345"
}
],
"status": "completed",
"intent": "plan",
"priority": "routine",
"code": {
"coding": [
{
"system": "http://www.ama-assn.org/go/cpt",
"code": "1111F",
"display": "Medication Reconciliation"
}
]
},
"for": {
"reference": "Patient/patient01"
},
"context": {
"reference": "Encounter/8592c13d-821a-bfef-74db-ae614e754d4f"
},
"authoredOn": "2018-12-12T17:54:03.934Z",
"executionPeriod": {
"start": "2018-12-12T17:54:03.934Z",
"end": "2018-12-12T17:54:03.934Z"
},
"owner": {
"reference": "Practitioner/practitioner01"
}
}
},
{
"name": "resource",
"resource": {
"resourceType": "Patient",
"id": "patient01",
"meta": {
"versionId": "4",
"lastUpdated": "2018-12-12T17:05:43.000+00:00",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
]
},
"text": {
"status": "generated",
"div": "<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>"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
"valueCode": "M"
},
{
"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": "12345"
}
],
"active": true,
"name": [
{
"use": "official",
"family": "Webster",
"given": [
"Jairo"
]
}
],
"gender": "male",
"birthDate": "1946-12-16",
"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
}
],
"managingOrganization": {
"reference": "Organization/organization01"
}
}
},
{
"name": "resource",
"resource": {
"resourceType": "Location",
"id": "location01",
"meta": {
"versionId": "2",
"lastUpdated": "2018-12-12T17:05:44.000+00:00",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location"
]
},
"name": "DaVinciClinic01",
"address": {
"line": [
"102 Heritage Dr."
],
"city": "Somerset",
"state": "NJ",
"postalCode": "08873",
"country": "USA"
}
}
},
{
"name": "resource",
"resource": {
"resourceType": "Practitioner",
"id": "practitioner01",
"meta": {
"versionId": "4",
"lastUpdated": "2018-12-12T17:05:43.000+00:00",
"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": "456789123"
}
],
"active": true,
"name": [
{
"family": "Hale",
"given": [
"Cody"
],
"suffix": [
"MD"
]
}
],
"gender": "male"
}
},
{
"name": "resource",
"resource": {
"resourceType": "Organization",
"id": "organization01",
"meta": {
"versionId": "4",
"lastUpdated": "2018-12-12T17:05:43.000+00:00",
"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"
}
]
}
},
{
"name": "resource",
"resource": {
"resourceType": "Encounter",
"id": "8592c13d-821a-bfef-74db-ae614e754d4f",
"meta": {
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
]
},
"status": "finished",
"class": {
"system": "http://hl7.org/fhir/v3/ActCode",
"code": "AMB",
"display": "ambulatory"
},
"type": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "390906007",
"display": "Follow-up encounter (procedure)"
}
]
}
],
"period": {
"start": "2018-12-12T17:54:03.934Z",
"end": "2018-12-12T17:54:03.934Z"
},
"subject": {
"reference": "Patient/patient01"
},
"location": [{
"location": {
"reference": "Location/location01"
}
}],
"participant": [
{
"individual": {
"reference": "Practitioner/practitioner01"
}
}
],
"serviceProvider": {
"reference": "Organization/organization01"
}
}
},
{
"name": "resource",
"resource": {
"resourceType": "Coverage",
"id": "coverage01",
"meta": {
"versionId": "2",
"lastUpdated": "2018-12-12T17:05:44.000+00:00",
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/coverage-deqm"
]
},
"policyHolder": {
"reference": "Patient/patient01"
},
"subscriber": {
"reference": "Patient/patient01"
},
"subscriberId": "A123456789",
"beneficiary": {
"reference": "Patient/patient01"
},
"relationship": {
"coding": [
{
"code": "self"
}
]
},
"payor": [
{
"reference": "Organization/organization04"
}
]
}
},
{
"name": "resource",
"resource": {
"resourceType": "Organization",
"id": "organization04",
"meta": {
"versionId": "4",
"lastUpdated": "2018-12-12T17:05:44.000+00:00",
"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": "456789123",
"assigner": {
"display": "www.irs.gov"
}
}
],
"active": true,
"type": [
{
"coding": [
{
"system": "http://hl7.org/fhir/organization-type",
"code": "ins",
"display": "Insurance Company"
}
]
}
],
"name": "DVPayer04-
",
"telecom": [
{
"system": "phone",
"value": "(+1) 616-555-1212"
}
],
"address": [
{
"line": [
"160 Glen Eagles Road"
],
"city": "Grand Rapids",
"state": "MI",
"postalCode": "49503",
"country": "USA"
}
]
}
}
]
}
Response
HTTP/1.1 200 OK
[other headers]
Examples
Scenario:
Provider X acting in the role of Producer submits MRP 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 MRP attestation using Observation as the resource used to evaluate the measure. An HTTP Status success code is returned on successful submission.
Request using POST
POST [base]/Measure/measure-mrp/$submit-data
Request body
{
"resourceType": "Parameters",
"id": "025ed5bb-a2e7-bf6f-0559-f37c14a0c79e",
"parameter": [
{
"name": "measure-report",
"resource":{
"resourceType": "MeasureReport",
"id": "datax-measurereport02",
"meta": {
"versionId": "1",
"lastUpdated": "2018-09-05T16:59:53.000+00:00",
"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-mrp"
},
"patient": {
"reference": "Patient/patient02"
},
"date": "2018-09-05T16:59:52.404Z",
"period": {
"start": "2018-08-01",
"end": "2018-09-01"
},
"evaluatedResources": {
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-referenceAny",
"valueReference": {
"reference": "Observation/observation01"
}
}
]
}
},
{
"name": "resource",
"resource": {
"resourceType": "Observation",
"id": "observation01",
"meta": {
"profile": [
"http://ncqa.org/fhir/us/hedis/StructureDefinition/hedis-observation"
]
},
"status": "final",
"category": [
{
"coding": [
{
"system": "http://acme.org/observation-category",
"code": "measure",
"display": "Measure"
}
]
}
],
"code": {
"coding": [
{
"system": "http://www.ama-assn.org/go/cpt",
"code": "1111F",
"display": "Medication Reconciliation"
}
]
},
"subject": {
"reference": "Patient/patient01"
},
"context": {
"reference": "Encounter/Encounter01"
},
"effectivePeriod": {
"start": "2018-09-29T14:15:04.424Z",
"end": "2018-09-29T14:15:04.424Z"
},
"issued": "2018-09-29T14:15:04.424Z",
"performer": [
{
"reference": "Practitioner/practitioner01"
}
],
"valueBoolean": true
}
,
{
"name": "resource",
"resource": {
"resourceType": "Patient",
"id": "patient01",
"meta": {
"versionId": "4",
"lastUpdated": "2018-12-12T17:05:43.000+00:00",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
]
},
"extension": [
{
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
"valueCode": "M"
},
{
"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": "12345"
}
],
"active": true,
"name": [
{
"use": "official",
"family": "Webster",
"given": [
"Jairo"
]
}
],
"gender": "male",
"birthDate": "1946-12-16",
"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
}
],
"managingOrganization": {
"reference": "Organization/organization01"
}
}
},
{
"name": "resource",
"resource": {
"resourceType": "Location",
"id": "location01",
"meta": {
"versionId": "2",
"lastUpdated": "2018-12-12T17:05:44.000+00:00",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location"
]
},
"name": "DaVinciClinic01",
"address": {
"line": [
"102 Heritage Dr."
],
"city": "Somerset",
"state": "NJ",
"postalCode": "08873",
"country": "USA"
}
}
},
{
"name": "resource",
"resource": {
"resourceType": "Practitioner",
"id": "practitioner01",
"meta": {
"versionId": "4",
"lastUpdated": "2018-12-12T17:05:43.000+00:00",
"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": "456789123"
}
],
"active": true,
"name": [
{
"family": "Hale",
"given": [
"Cody"
],
"suffix": [
"MD"
]
}
],
"gender": "male"
}
},
{
"name": "resource",
"resource": {
"resourceType": "Organization",
"id": "organization01",
"meta": {
"versionId": "4",
"lastUpdated": "2018-12-12T17:05:43.000+00:00",
"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"
}
]
}
},
{
"name": "resource",
"resource": {
"resourceType": "Encounter",
"id": "Encounter01",
"meta": {
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
]
},
"status": "finished",
"class": {
"system": "http://hl7.org/fhir/v3/ActCode",
"code": "AMB",
"display": "ambulatory"
},
"type": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "390906007",
"display": "Follow-up encounter (procedure)"
}
]
}
],
"period": {
"start": "2018-12-12T17:54:03.934Z",
"end": "2018-12-12T17:54:03.934Z"
},
"subject": {
"reference": "Patient/patient01"
},
"location": [{
"location": {
"reference": "Location/location01"
}
}],
"participant": [
{
"individual": {
"reference": "Practitioner/practitioner01"
}
}
],
"serviceProvider": {
"reference": "Organization/organization01"
}
}
},
{
"name": "resource",
"resource": {
"resourceType": "Coverage",
"id": "coverage01",
"meta": {
"versionId": "2",
"lastUpdated": "2018-12-12T17:05:44.000+00:00",
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/coverage-deqm"
]
},
"policyHolder": {
"reference": "Patient/patient01"
},
"subscriber": {
"reference": "Patient/patient01"
},
"subscriberId": "A123456789",
"beneficiary": {
"reference": "Patient/patient01"
},
"relationship": {
"coding": [
{
"code": "self"
}
]
},
"payor": [
{
"reference": "Organization/organization04"
}
]
}
},
{
"name": "resource",
"resource": {
"resourceType": "Organization",
"id": "organization04",
"meta": {
"versionId": "4",
"lastUpdated": "2018-12-12T17:05:44.000+00:00",
"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": "456789123",
"assigner": {
"display": "www.irs.gov"
}
}
],
"active": true,
"type": [
{
"coding": [
{
"system": "http://hl7.org/fhir/organization-type",
"code": "ins",
"display": "Insurance Company"
}
]
}
],
"name": "DVPayer04-
",
"telecom": [
{
"system": "phone",
"value": "(+1) 616-555-1212"
}
],
"address": [
{
"line": [
"160 Glen Eagles Road"
],
"city": "Grand Rapids",
"state": "MI",
"postalCode": "49503",
"country": "USA"
}
]
}
}
]
}
Response
HTTP/1.1 200 OK
[other headers]
MRP Measure Reporting Interactions
In the following interactions, The Payer (“Aggregator”) is acting in the role of the Reporter.
Individual MeasureReport
The Payer (“Aggregator”) pushes the Bundle of supporting resources with the MRP Individual MeasureReport Bundle to the Receiver.
Examples
Scenario:
Payer X who is acting in the role of a Reporter submits a MRP Individual Report for Patient P to Receiver Z. The body of the request is a transaction bundle including the Individual MeasureReport and Task resources 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 Summary Report
POST [base]
Request body
{
"id": "indv-report01",
"entry": [
{
"fullUrl": "urn:uuid:a5481b62-45e7-11e9-b20c-5cf3707b2e61",
"request": {
"method": "POST",
"url": "Coverage"
},
"resource": {
"meta": {
"lastUpdated": "2019-02-11T14:19:25.000+00:00",
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/coverage-deqm"
],
"versionId": "2"
},
"beneficiary": {
"reference": "urn:uuid:a54890a3-45e7-11e9-8814-5cf3707b2e61"
},
"payor": [
{
"reference": "Organization/organization04"
}
],
"policyHolder": {
"reference": "urn:uuid:a54890a3-45e7-11e9-8814-5cf3707b2e61"
},
"relationship": {
"coding": [
{
"code": "self"
}
]
},
"subscriber": {
"reference": "urn:uuid:a54890a3-45e7-11e9-8814-5cf3707b2e61"
},
"subscriberId": "A123456789",
"resourceType": "Coverage"
}
},
{
"fullUrl": "urn:uuid:a548418c-45e7-11e9-b2e8-5cf3707b2e61",
"request": {
"method": "POST",
"url": "Encounter"
},
"resource": {
"meta": {
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
]
},
"class": {
"code": "IMP",
"display": "inpatient encounter",
"system": "http://hl7.org/fhir/v3/ActCode"
},
"hospitalization": {
"dischargeDisposition": {
"coding": [
{
"code": "home",
"display": "Home",
"system": "http://hl7.org/fhir/discharge-disposition"
}
]
}
},
"period": {
"end": "2018-05-29T11:00:00-04:00",
"start": "2018-05-29T11:00:00-04:00"
},
"status": "finished",
"subject": {
"display": "Natalie Huff Walter",
"reference": "urn:uuid:a54890a3-45e7-11e9-8814-5cf3707b2e61"
},
"type": [
{
"coding": [
{
"code": "56876005",
"display": "Drug rehabilitation and detoxification",
"system": "http://snomed.info/sct"
}
]
}
],
"resourceType": "Encounter"
}
},
{
"fullUrl": "urn:uuid:a548418d-45e7-11e9-a7b9-5cf3707b2e61",
"request": {
"method": "POST",
"url": "Location"
},
"resource": {
"meta": {
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location"
]
},
"address": {
"city": "Somerset",
"country": "USA",
"line": [
"102 Heritage Dr."
],
"postalCode": "08873",
"state": "NJ"
},
"name": "DaVinciClinic01",
"resourceType": "Location"
}
},
{
"fullUrl": "urn:uuid:a548689e-45e7-11e9-9b0c-5cf3707b2e61",
"request": {
"method": "POST",
"url": "MeasureReport"
},
"resource": {
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"
]
},
"extension": [
{
"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": "urn:uuid:a54890a2-45e7-11e9-bdf7-5cf3707b2e61"
}
}
],
"date": "2018-09-05T16:59:52.404Z",
"evaluatedResources": {
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-referenceAny",
"valueReference": {
"reference": "urn:uuid:a548de80-45e7-11e9-83b6-5cf3707b2e61"
}
}
]
},
"group": [
{
"identifier": {
"system": "http://www.acme.org/groups",
"value": "112"
},
"measureScore": 100,
"population": [
{
"code": {
"coding": [
{
"code": "initial-population",
"display": "Initial Population",
"system": "http://hl7.org/fhir/measure-population"
}
]
},
"identifier": {
"system": "http://www.acme.org/populations",
"value": "11234"
}
}
]
}
],
"measure": {
"reference": "Measure/measure-mrp"
},
"patient": {
"reference": "urn:uuid:a54890a3-45e7-11e9-8814-5cf3707b2e61"
},
"period": {
"end": "2018-09-01",
"start": "2018-08-01"
},
"reportingOrganization": {
"reference": "urn:uuid:a548689f-45e7-11e9-8e8f-5cf3707b2e61"
},
"status": "complete",
"type": "individual",
"resourceType": "MeasureReport"
}
},
{
"fullUrl": "urn:uuid:a548689f-45e7-11e9-8e8f-5cf3707b2e61",
"request": {
"method": "POST",
"url": "Organization"
},
"resource": {
"meta": {
"lastUpdated": "2019-02-21T01:47:54.000+00:00",
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
],
"versionId": "4"
},
"active": true,
"address": [
{
"city": "Warwick",
"country": "USA",
"line": [
"73 Lakewood Street"
],
"postalCode": "02886",
"state": "RI"
}
],
"identifier": [
{
"assigner": {
"display": "www.irs.gov"
},
"system": "urn:oid:2.16.840.1.113883.4.2",
"type": {
"coding": [
{
"code": "TAX",
"display": "Tax ID number",
"system": "http://hl7.org/fhir/v2/0203"
}
]
},
"use": "official",
"value": "123456789"
}
],
"name": "DaVinciHospital01",
"telecom": [
{
"system": "phone",
"value": "(+1) 401-555-1212"
}
],
"type": [
{
"coding": [
{
"code": "prov",
"display": "Healthcare Provider",
"system": "http://hl7.org/fhir/organization-type"
}
]
}
],
"resourceType": "Organization"
}
},
{
"fullUrl": "urn:uuid:a54890a2-45e7-11e9-bdf7-5cf3707b2e61",
"request": {
"method": "POST",
"url": "Organization"
},
"resource": {
"meta": {
"lastUpdated": "2019-03-06T19:03:03.000+00:00",
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
],
"versionId": "3"
},
"active": true,
"address": [
{
"city": "Englewood",
"country": "USA",
"line": [
"3 Sherwood St."
],
"postalCode": "07631",
"state": "NJ"
}
],
"identifier": [
{
"assigner": {
"display": "www.irs.gov"
},
"system": "urn:oid:2.16.840.1.113883.4.2",
"type": {
"coding": [
{
"code": "TAX",
"display": "Tax ID number",
"system": "http://hl7.org/fhir/v2/0203"
}
]
},
"use": "official",
"value": "234567891"
}
],
"name": "DaVinciHospital02",
"telecom": [
{
"system": "phone",
"value": "(+1) 551-555-1212"
}
],
"type": [
{
"coding": [
{
"code": "prov",
"display": "Healthcare Provider",
"system": "http://hl7.org/fhir/organization-type"
}
]
}
],
"resourceType": "Organization"
}
},
{
"fullUrl": "urn:uuid:a54890a3-45e7-11e9-8814-5cf3707b2e61",
"request": {
"method": "POST",
"url": "Patient"
},
"resource": {
"meta": {
"lastUpdated": "2019-02-11T14:19:25.000+00:00",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
],
"versionId": "5"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
"valueCode": "M"
},
{
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"code": "2106-3",
"display": "White",
"system": "urn:oid:2.16.840.1.113883.6.238"
}
},
{
"url": "text",
"valueString": "White"
}
],
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
},
{
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"code": "2186-5",
"display": "Not Hispanic or Latino",
"system": "urn:oid:2.16.840.1.113883.6.238"
}
},
{
"url": "text",
"valueString": "Not Hispanic or Latino"
}
],
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
}
],
"active": true,
"address": [
{
"city": "Thornton",
"country": "USA",
"line": [
"7496 Beaver Ridge Ave"
],
"postalCode": "07003",
"state": "NJ",
"use": "home"
}
],
"birthDate": "1946-12-16",
"communication": [
{
"language": {
"coding": [
{
"code": "en-US",
"display": "US English",
"system": "urn:ietf:bcp:47"
}
]
},
"preferred": true
}
],
"deceasedBoolean": false,
"gender": "male",
"identifier": [
{
"system": "http://hospital.davinci.org",
"type": {
"coding": [
{
"code": "MR",
"display": "Medical record number",
"system": "http://hl7.org/fhir/v2/0203"
}
]
},
"use": "usual",
"value": "12345"
}
],
"managingOrganization": {
"reference": "urn:uuid:a548689f-45e7-11e9-8e8f-5cf3707b2e61"
},
"maritalStatus": {
"coding": [
{
"code": "M",
"display": "Married",
"system": "http://hl7.org/fhir/v3/MaritalStatus"
}
]
},
"name": [
{
"family": "Webster",
"given": [
"Jairo"
],
"use": "official"
}
],
"resourceType": "Patient"
}
},
{
"fullUrl": "urn:uuid:a548b76e-45e7-11e9-aed5-5cf3707b2e61",
"request": {
"method": "POST",
"url": "Practitioner"
},
"resource": {
"meta": {
"lastUpdated": "2019-03-06T19:03:03.000+00:00",
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/practitioner-deqm"
],
"versionId": "4"
},
"active": true,
"gender": "male",
"identifier": [
{
"system": "http://hl7.org/fhir/sid/us-npi",
"type": {
"coding": [
{
"code": "PRN",
"display": "Provider number",
"system": "http://hl7.org/fhir/v2/0203"
}
]
},
"use": "official",
"value": "456789123"
}
],
"name": [
{
"family": "Hale",
"given": [
"Cody"
],
"suffix": [
"MD"
]
}
],
"resourceType": "Practitioner"
}
},
{
"fullUrl": "urn:uuid:a548de80-45e7-11e9-83b6-5cf3707b2e61",
"request": {
"method": "POST",
"url": "Task"
},
"resource": {
"meta": {
"profile": [
"http://ncqa.org/fhir/us/hedis/StructureDefinition/hedis-task"
]
},
"authoredOn": "2018-09-25T14:24:23.584Z",
"code": {
"coding": [
{
"code": "1111F",
"display": "Medication Reconciliation",
"system": "http://www.ama-assn.org/go/cpt"
}
]
},
"context": {
"reference": "urn:uuid:a548418c-45e7-11e9-b2e8-5cf3707b2e61"
},
"executionPeriod": {
"end": "2017-06-11",
"start": "2017-06-11"
},
"for": {
"reference": "urn:uuid:a54890a3-45e7-11e9-8814-5cf3707b2e61"
},
"identifier": [
{
"system": "http://www.acme.org/tasks",
"value": "19009"
}
],
"intent": "plan",
"owner": {
"reference": "urn:uuid:a548b76e-45e7-11e9-aed5-5cf3707b2e61"
},
"priority": "routine",
"status": "completed",
"resourceType": "Task"
}
}
],
"type": "transaction",
"resourceType": "Bundle"
}
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/datax-measurereport01/_history/1",
"etag": "1",
"lastModified": "2019-03-13T01:02:05.901+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Task/Task01/_history/1",
"etag": "1",
"lastModified": "2019-03-13T01:02:05.932+00:00"
}
},
{
"response": {
"status": "200 OK",
"location": "Patient/patient01/_history/4",
"etag": "4",
"lastModified": "2018-12-12T17:05:43.000+00:00"
}
},
{
"response": {
"status": "200 OK",
"location": "Location/location01/_history/2",
"etag": "2",
"lastModified": "2018-12-12T17:05:44.000+00:00"
}
},
{
"response": {
"status": "200 OK",
"location": "Practitioner/practitioner01/_history/4",
"etag": "4",
"lastModified": "2018-12-12T17:05:43.000+00:00"
}
},
{
"response": {
"status": "200 OK",
"location": "Organization/organization01/_history/4",
"etag": "4",
"lastModified": "2018-12-12T17:05:43.000+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Encounter/8592c13d-821a-bfef-74db-ae614e754d4f/_history/1",
"etag": "1",
"lastModified": "2019-03-13T01:02:05.965+00:00"
}
},
{
"response": {
"status": "200 OK",
"location": "Coverage/coverage01/_history/2",
"etag": "2",
"lastModified": "2018-12-12T17:05:44.000+00:00"
}
},
{
"response": {
"status": "200 OK",
"location": "Organization/organization04/_history/4",
"etag": "4",
"lastModified": "2018-12-12T17:05:44.000+00:00"
}
}
]
}
]
Examples
Scenario:
Reporter X submits a MRP Individual Report for Patient P to Receiver Z. The body of the request is a transaction bundle including the Individual MeasureReport and Observation resources 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 Summary Report
POST [base]
Request body
{
"id": "indv-report02",
"entry": [
{
"fullUrl": "urn:uuid:0152d3a2-45e9-11e9-b386-5cf3707b2e61",
"request": {
"method": "POST",
"url": "Coverage"
},
"resource": {
"meta": {
"lastUpdated": "2019-02-11T14:19:25.000+00:00",
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/coverage-deqm"
],
"versionId": "2"
},
"beneficiary": {
"reference": "urn:uuid:015c69cb-45e9-11e9-b16f-5cf3707b2e61"
},
"payor": [
{
"reference": "Organization/organization04"
}
],
"policyHolder": {
"reference": "urn:uuid:015c69cb-45e9-11e9-b16f-5cf3707b2e61"
},
"relationship": {
"coding": [
{
"code": "self"
}
]
},
"subscriber": {
"reference": "urn:uuid:015c69cb-45e9-11e9-b16f-5cf3707b2e61"
},
"subscriberId": "A123456789",
"resourceType": "Coverage"
}
},
{
"fullUrl": "urn:uuid:0152fa74-45e9-11e9-a9b8-5cf3707b2e61",
"request": {
"method": "POST",
"url": "Encounter"
},
"resource": {
"meta": {
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
]
},
"class": {
"code": "IMP",
"display": "inpatient encounter",
"system": "http://hl7.org/fhir/v3/ActCode"
},
"hospitalization": {
"dischargeDisposition": {
"coding": [
{
"code": "home",
"display": "Home",
"system": "http://hl7.org/fhir/discharge-disposition"
}
]
}
},
"period": {
"end": "2018-05-29T11:00:00-04:00",
"start": "2018-05-29T11:00:00-04:00"
},
"status": "finished",
"subject": {
"display": "Natalie Huff Walter",
"reference": "urn:uuid:015c69cb-45e9-11e9-b16f-5cf3707b2e61"
},
"type": [
{
"coding": [
{
"code": "56876005",
"display": "Drug rehabilitation and detoxification",
"system": "http://snomed.info/sct"
}
]
}
],
"resourceType": "Encounter"
}
},
{
"fullUrl": "urn:uuid:0152fa75-45e9-11e9-82fc-5cf3707b2e61",
"request": {
"method": "POST",
"url": "Location"
},
"resource": {
"meta": {
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location"
]
},
"address": {
"city": "Somerset",
"country": "USA",
"line": [
"102 Heritage Dr."
],
"postalCode": "08873",
"state": "NJ"
},
"name": "DaVinciClinic01",
"resourceType": "Location"
}
},
{
"fullUrl": "urn:uuid:0153484c-45e9-11e9-8806-5cf3707b2e61",
"request": {
"method": "POST",
"url": "MeasureReport"
},
"resource": {
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"
]
},
"extension": [
{
"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": "urn:uuid:015c69ca-45e9-11e9-ac61-5cf3707b2e61"
}
}
],
"date": "2018-09-05T16:59:52.404Z",
"evaluatedResources": {
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-referenceAny",
"valueReference": {
"reference": "urn:uuid:01536f40-45e9-11e9-983b-5cf3707b2e61"
}
}
]
},
"group": [
{
"identifier": {
"system": "http://www.acme.org/groups",
"value": "112"
},
"measureScore": 100,
"population": [
{
"code": {
"coding": [
{
"code": "initial-population",
"display": "Initial Population",
"system": "http://hl7.org/fhir/measure-population"
}
]
},
"identifier": {
"system": "http://www.acme.org/populations",
"value": "11234"
}
}
]
}
],
"measure": {
"reference": "Measure/measure-mrp"
},
"patient": {
"reference": "urn:uuid:015c69cb-45e9-11e9-b16f-5cf3707b2e61"
},
"period": {
"end": "2018-09-01",
"start": "2018-08-01"
},
"reportingOrganization": {
"reference": "urn:uuid:015c42d4-45e9-11e9-8641-5cf3707b2e61"
},
"status": "complete",
"type": "individual",
"resourceType": "MeasureReport"
}
},
{
"fullUrl": "urn:uuid:01536f40-45e9-11e9-983b-5cf3707b2e61",
"request": {
"method": "POST",
"url": "Observation"
},
"resource": {
"meta": {
"profile": [
"http://ncqa.org/fhir/us/hedis/StructureDefinition/hedis-observation"
]
},
"category": [
{
"coding": [
{
"code": "measure",
"display": "Measure",
"system": "http://acme.org/observation-category"
}
]
}
],
"code": {
"coding": [
{
"code": "1111F",
"display": "Medication Reconciliation",
"system": "http://www.ama-assn.org/go/cpt"
}
]
},
"context": {
"reference": "urn:uuid:0152fa74-45e9-11e9-a9b8-5cf3707b2e61"
},
"effectivePeriod": {
"end": "2018-09-29T14:15:04.424Z",
"start": "2018-09-29T14:15:04.424Z"
},
"issued": "2018-09-29T14:15:04.424Z",
"performer": [
{
"reference": "urn:uuid:015c90be-45e9-11e9-9435-5cf3707b2e61"
}
],
"status": "final",
"subject": {
"reference": "urn:uuid:015c69cb-45e9-11e9-b16f-5cf3707b2e61"
},
"valueBoolean": true,
"resourceType": "Observation"
}
},
{
"fullUrl": "urn:uuid:015c42d4-45e9-11e9-8641-5cf3707b2e61",
"request": {
"method": "POST",
"url": "Organization"
},
"resource": {
"meta": {
"lastUpdated": "2019-02-21T01:47:54.000+00:00",
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
],
"versionId": "4"
},
"active": true,
"address": [
{
"city": "Warwick",
"country": "USA",
"line": [
"73 Lakewood Street"
],
"postalCode": "02886",
"state": "RI"
}
],
"identifier": [
{
"assigner": {
"display": "www.irs.gov"
},
"system": "urn:oid:2.16.840.1.113883.4.2",
"type": {
"coding": [
{
"code": "TAX",
"display": "Tax ID number",
"system": "http://hl7.org/fhir/v2/0203"
}
]
},
"use": "official",
"value": "123456789"
}
],
"name": "DaVinciHospital01",
"telecom": [
{
"system": "phone",
"value": "(+1) 401-555-1212"
}
],
"type": [
{
"coding": [
{
"code": "prov",
"display": "Healthcare Provider",
"system": "http://hl7.org/fhir/organization-type"
}
]
}
],
"resourceType": "Organization"
}
},
{
"fullUrl": "urn:uuid:015c69ca-45e9-11e9-ac61-5cf3707b2e61",
"request": {
"method": "POST",
"url": "Organization"
},
"resource": {
"meta": {
"lastUpdated": "2019-03-06T19:03:03.000+00:00",
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm"
],
"versionId": "3"
},
"active": true,
"address": [
{
"city": "Englewood",
"country": "USA",
"line": [
"3 Sherwood St."
],
"postalCode": "07631",
"state": "NJ"
}
],
"identifier": [
{
"assigner": {
"display": "www.irs.gov"
},
"system": "urn:oid:2.16.840.1.113883.4.2",
"type": {
"coding": [
{
"code": "TAX",
"display": "Tax ID number",
"system": "http://hl7.org/fhir/v2/0203"
}
]
},
"use": "official",
"value": "234567891"
}
],
"name": "DaVinciHospital02",
"telecom": [
{
"system": "phone",
"value": "(+1) 551-555-1212"
}
],
"type": [
{
"coding": [
{
"code": "prov",
"display": "Healthcare Provider",
"system": "http://hl7.org/fhir/organization-type"
}
]
}
],
"resourceType": "Organization"
}
},
{
"fullUrl": "urn:uuid:015c69cb-45e9-11e9-b16f-5cf3707b2e61",
"request": {
"method": "POST",
"url": "Patient"
},
"resource": {
"meta": {
"lastUpdated": "2019-02-11T14:19:25.000+00:00",
"profile": [
"http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
],
"versionId": "5"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
"valueCode": "M"
},
{
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"code": "2106-3",
"display": "White",
"system": "urn:oid:2.16.840.1.113883.6.238"
}
},
{
"url": "text",
"valueString": "White"
}
],
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
},
{
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"code": "2186-5",
"display": "Not Hispanic or Latino",
"system": "urn:oid:2.16.840.1.113883.6.238"
}
},
{
"url": "text",
"valueString": "Not Hispanic or Latino"
}
],
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
}
],
"active": true,
"address": [
{
"city": "Thornton",
"country": "USA",
"line": [
"7496 Beaver Ridge Ave"
],
"postalCode": "07003",
"state": "NJ",
"use": "home"
}
],
"birthDate": "1946-12-16",
"communication": [
{
"language": {
"coding": [
{
"code": "en-US",
"display": "US English",
"system": "urn:ietf:bcp:47"
}
]
},
"preferred": true
}
],
"deceasedBoolean": false,
"gender": "male",
"identifier": [
{
"system": "http://hospital.davinci.org",
"type": {
"coding": [
{
"code": "MR",
"display": "Medical record number",
"system": "http://hl7.org/fhir/v2/0203"
}
]
},
"use": "usual",
"value": "12345"
}
],
"managingOrganization": {
"reference": "urn:uuid:015c42d4-45e9-11e9-8641-5cf3707b2e61"
},
"maritalStatus": {
"coding": [
{
"code": "M",
"display": "Married",
"system": "http://hl7.org/fhir/v3/MaritalStatus"
}
]
},
"name": [
{
"family": "Webster",
"given": [
"Jairo"
],
"use": "official"
}
],
"resourceType": "Patient"
}
},
{
"fullUrl": "urn:uuid:015c90be-45e9-11e9-9435-5cf3707b2e61",
"request": {
"method": "POST",
"url": "Practitioner"
},
"resource": {
"meta": {
"lastUpdated": "2019-03-06T19:03:03.000+00:00",
"profile": [
"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/practitioner-deqm"
],
"versionId": "4"
},
"active": true,
"gender": "male",
"identifier": [
{
"system": "http://hl7.org/fhir/sid/us-npi",
"type": {
"coding": [
{
"code": "PRN",
"display": "Provider number",
"system": "http://hl7.org/fhir/v2/0203"
}
]
},
"use": "official",
"value": "456789123"
}
],
"name": [
{
"family": "Hale",
"given": [
"Cody"
],
"suffix": [
"MD"
]
}
],
"resourceType": "Practitioner"
}
}
],
"type": "transaction",
"resourceType": "Bundle"
}
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/datax-measurereport02/_history/1",
"etag": "1",
"lastModified": "2019-03-13T01:02:05.901+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Observation/observation01/_history/1",
"etag": "1",
"lastModified": "2019-03-13T01:02:05.932+00:00"
}
},
{
"response": {
"status": "200 OK",
"location": "Patient/patient01/_history/4",
"etag": "4",
"lastModified": "2018-12-12T17:05:43.000+00:00"
}
},
{
"response": {
"status": "200 OK",
"location": "Location/location01/_history/2",
"etag": "2",
"lastModified": "2018-12-12T17:05:44.000+00:00"
}
},
{
"response": {
"status": "200 OK",
"location": "Practitioner/practitioner01/_history/4",
"etag": "4",
"lastModified": "2018-12-12T17:05:43.000+00:00"
}
},
{
"response": {
"status": "200 OK",
"location": "Organization/organization01/_history/4",
"etag": "4",
"lastModified": "2018-12-12T17:05:43.000+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Encounter/Encounter01/history/2",
"etag": "1",
"lastModified": "2019-03-13T01:02:05.965+00:00"
}
},
{
"response": {
"status": "200 OK",
"location": "Coverage/coverage01/_history/2",
"etag": "2",
"lastModified": "2018-12-12T17:05:44.000+00:00"
}
},
{
"response": {
"status": "200 OK",
"location": "Organization/organization04/_history/4",
"etag": "4",
"lastModified": "2018-12-12T17:05:44.000+00:00"
}
}
]
}
Summary MeasureReport
The Payer (“Aggregator”) pushes the MRP Summary MeasureReport to the Receiver.
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": {
"profile": [
"http://hl7.org/fhir/ig/davinci/StructureDefinition/summary-measurereport-deqm"
]
},
"status": "complete",
"type": "summary",
"measure": {
"reference": "Measure/measure-mrp"
},
"date": "2018-09-05T16:59:52.404Z",
"period": {
"start": "2018-08-01",
"end": "2018-09-01"
},
"reportingOrganization": {
"reference": "Organization/organization01"
},
"group": [
{
"identifier": {
"system": "http://www.acme.org/groups",
"value": "112"
},
"population": [
{
"identifier": {
"system": "http://www.acme.org/populations",
"value": "11234"
},
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/measure-population",
"code": "initial-population",
"display": "Initial Population"
}
]
},
"count": 100
}
],
"measureScore": 100,
"stratifier": [
{
"identifier": {
"system": "http://www.acme.org/stratifiers",
"value": "4456"
},
"stratum": [
{
"value": "male",
"population": [
{
"identifier": {
"system": "http://www.acme.org/stratifier-populations",
"value": "8901"
},
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/measure-population",
"code": "initial-population",
"display": "Initial Population"
}
]
},
"count": 50
}
],
"measureScore": 100
}
]
}
]
}
]
}
Response
HTTP/1.1 200 OK
[other headers]
