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 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

: Mrp Submit Obs - JSON Representation

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{
  "resourceType" : "Parameters",
  "id" : "mrp-submit-obs",
  "meta" : {
    "source" : "http://example.org/fhir/server"
  },
  "parameter" : [
    {
      "name" : "measureReport",
      "resource" : {
        "resourceType" : "MeasureReport",
        "id" : "datax-measurereport02",
        "meta" : {
          "versionId" : "1",
          "lastUpdated" : "2018-09-05T16:59:53.000+00:00",
          "source" : "http://example.org/fhir/server",
          "profile" : [
            "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/datax-measurereport-deqm"
          ]
        },
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-submitDataUpdateType",
            "valueCode" : "incremental"
          }
        ],
        "status" : "complete",
        "type" : "data-collection",
        "measure" : "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
        "subject" : {
          "reference" : "Patient/patient02"
        },
        "date" : "2018-09-05T16:59:52.404Z",
        "reporter" : {
          "reference" : "Organization/organization01"
        },
        "period" : {
          "start" : "2018-08-01",
          "end" : "2018-09-01"
        },
        "evaluatedResource" : [
          {
            "reference" : "Observation/observation01"
          }
        ]
      }
    },
    {
      "name" : "resource",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "patient01",
        "meta" : {
          "versionId" : "5",
          "lastUpdated" : "2019-02-11T14:19:25.000+00:00",
          "source" : "http://example.org/fhir/server",
          "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"
          },
          {
            "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-race"
          },
          {
            "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"
              }
            ],
            "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
          }
        ],
        "identifier" : [
          {
            "use" : "usual",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/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://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
              "code" : "M",
              "display" : "Married"
            }
          ]
        },
        "communication" : [
          {
            "language" : {
              "coding" : [
                {
                  "system" : "urn:ietf:bcp:47",
                  "code" : "en-US",
                  "display" : "English (Region=United States)"
                }
              ]
            },
            "preferred" : true
          }
        ],
        "managingOrganization" : {
          "reference" : "Organization/organization01"
        }
      }
    },
    {
      "name" : "resource",
      "resource" : {
        "resourceType" : "Observation",
        "id" : "observation01",
        "meta" : {
          "source" : "http://example.org/fhir/server",
          "profile" : [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"
          ]
        },
        "status" : "final",
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                "code" : "exam",
                "display" : "Exam"
              }
            ]
          }
        ],
        "code" : {
          "coding" : [
            {
              "system" : "http://www.ama-assn.org/go/cpt",
              "code" : "1111F",
              "display" : "Discharge medications reconciled with the current medication list in outpatient medical record (COA) (GER)"
            }
          ]
        },
        "subject" : {
          "reference" : "Patient/patient01"
        },
        "encounter" : {
          "reference" : "Encounter/encounter01"
        },
        "effectiveDateTime" : "2018-09-29T14:15:04.424Z",
        "issued" : "2018-09-29T14:15:04.424Z",
        "performer" : [
          {
            "reference" : "Practitioner/practitioner01"
          }
        ],
        "valueBoolean" : true
      }
    },
    {
      "name" : "resource",
      "resource" : {
        "resourceType" : "Practitioner",
        "id" : "practitioner01",
        "meta" : {
          "source" : "http://example.org/fhir/server",
          "profile" : [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"
          ]
        },
        "identifier" : [
          {
            "use" : "official",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/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" : "Encounter",
        "id" : "encounter01",
        "meta" : {
          "source" : "http://example.org/fhir/server",
          "profile" : [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"
          ]
        },
        "status" : "finished",
        "class" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code" : "IMP",
          "display" : "inpatient encounter"
        },
        "type" : [
          {
            "coding" : [
              {
                "system" : "http://snomed.info/sct",
                "code" : "56876005",
                "display" : "Drug rehabilitation and detoxification"
              }
            ]
          }
        ],
        "subject" : {
          "reference" : "Patient/patient01",
          "display" : "Jairo Webster"
        },
        "period" : {
          "start" : "2018-05-29T11:00:00-04:00",
          "end" : "2018-05-29T11:00:00-04:00"
        },
        "hospitalization" : {
          "dischargeDisposition" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/discharge-disposition",
                "code" : "home",
                "display" : "Home"
              }
            ]
          }
        }
      }
    },
    {
      "name" : "resource",
      "resource" : {
        "resourceType" : "Coverage",
        "id" : "coverage01",
        "meta" : {
          "versionId" : "2",
          "lastUpdated" : "2019-02-11T14:19:25.000+00:00",
          "source" : "http://example.org/fhir/server",
          "profile" : [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"
          ]
        },
        "status" : "active",
        "policyHolder" : {
          "reference" : "Patient/patient01"
        },
        "subscriber" : {
          "reference" : "Patient/patient01"
        },
        "subscriberId" : "A123456789",
        "beneficiary" : {
          "reference" : "Patient/patient01"
        },
        "relationship" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
              "code" : "self"
            }
          ]
        },
        "payor" : [
          {
            "reference" : "Organization/organization04"
          }
        ]
      }
    },
    {
      "name" : "resource",
      "resource" : {
        "resourceType" : "Location",
        "id" : "location01",
        "meta" : {
          "source" : "http://example.org/fhir/server",
          "profile" : [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location"
          ]
        },
        "identifier" : [
          {
            "use" : "temp",
            "system" : "http://exampleoflocation.com",
            "value" : "DaVinciClinic01"
          }
        ],
        "name" : "DaVinciClinic01",
        "address" : {
          "line" : [
            "102 Heritage Dr."
          ],
          "city" : "Somerset",
          "state" : "NJ",
          "postalCode" : "08873",
          "country" : "USA"
        }
      }
    },
    {
      "name" : "resource",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "organization01",
        "meta" : {
          "versionId" : "4",
          "lastUpdated" : "2019-02-21T01:47:54.000+00:00",
          "source" : "http://example.org/fhir/server",
          "profile" : [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"
          ]
        },
        "identifier" : [
          {
            "use" : "official",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "TAX",
                  "display" : "Tax ID number"
                }
              ]
            },
            "system" : "urn:oid:2.16.840.1.113883.4.4",
            "value" : "123456789",
            "assigner" : {
              "display" : "www.irs.gov"
            }
          }
        ],
        "active" : true,
        "type" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/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" : "Organization",
        "id" : "organization02",
        "meta" : {
          "versionId" : "3",
          "lastUpdated" : "2019-03-06T19:03:03.000+00:00",
          "source" : "http://example.org/fhir/server",
          "profile" : [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"
          ]
        },
        "identifier" : [
          {
            "use" : "official",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "TAX",
                  "display" : "Tax ID number"
                }
              ]
            },
            "system" : "urn:oid:2.16.840.1.113883.4.4",
            "value" : "234567891",
            "assigner" : {
              "display" : "www.irs.gov"
            }
          }
        ],
        "active" : true,
        "type" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
                "code" : "prov",
                "display" : "Healthcare Provider"
              }
            ]
          }
        ],
        "name" : "DaVinciHospital02",
        "telecom" : [
          {
            "system" : "phone",
            "value" : "(+1) 551-555-1212"
          }
        ],
        "address" : [
          {
            "line" : [
              "3 Sherwood St."
            ],
            "city" : "Englewood",
            "state" : "NJ",
            "postalCode" : "07631",
            "country" : "USA"
          }
        ]
      }
    },
    {
      "name" : "resource",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "organization04",
        "meta" : {
          "versionId" : "4",
          "lastUpdated" : "2019-03-06T19:03:03.000+00:00",
          "source" : "http://example.org/fhir/server",
          "profile" : [
            "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"
          ]
        },
        "identifier" : [
          {
            "use" : "official",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "TAX",
                  "display" : "Tax ID number"
                }
              ]
            },
            "system" : "urn:oid:2.16.840.1.113883.4.4",
            "value" : "456789123",
            "assigner" : {
              "display" : "www.irs.gov"
            }
          }
        ],
        "active" : true,
        "type" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/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"
          }
        ]
      }
    }
  ]
}