This page is part of the Da Vinci Data Exchange for Quality Measures (DEQM) FHIR IG (v3.1.0: STU 3) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
<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://example.org/CodeSystem/observation-category"/>
<code value="measure"/>
<display value="Measure"/>
</coding>
</category>
<code>
<coding>
<system value="http://www.ama-assn.org/go/cpt"/>
<code value="1111F"/>
<display value="Medication Reconciliation"/>
</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/davinci-deqm/StructureDefinition/practitioner-deqm"/>
</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/davinci-deqm/StructureDefinition/coverage-deqm"/>
</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>
IG © 2020+ HL7 International - Clinical Quality Information Work Group. Package hl7.fhir.us.davinci-deqm#3.1.0 based on FHIR 4.0.1. Generated 2022-11-21
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