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

Medication Reconciliation Post-Discharge (MRP)

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 QI Core Organization Profile QI Core 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
Figure 3-1 MRP Using Task
mrp-task.png

Figure 3-2 MRP Using Observation
mrp-observation.png

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",
  "id" : "library-mrp-example",
  "meta" : {
    "source" : "http://example.org/fhir/server"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Data Requirements</h2><table class=\"grid\"><tr><td colspan=\"2\"><b>Type</b>: <a href=\"http://hl7.org/fhir/R4/measurereport.html\">MeasureReport</a> (<a href=\"StructureDefinition-datax-measurereport-deqm.html\">DEQM Data Exchange MeasureReport Profile</a>)</td></tr></table><table class=\"grid\"><tr><td colspan=\"2\"><b>Type</b>: <a href=\"http://hl7.org/fhir/R4/patient.html\">Patient</a> (<a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-patient.html\">QICore Patient</a>)</td></tr></table><table class=\"grid\"><tr><td colspan=\"2\"><b>Type</b>: <a href=\"http://hl7.org/fhir/R4/encounter.html\">Encounter</a> (<a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-encounter.html\">QICore Encounter</a>)</td></tr></table><table class=\"grid\"><tr><td colspan=\"2\"><b>Type</b>: <a href=\"http://hl7.org/fhir/R4/location.html\">Location</a> (<a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-location.html\">QICore Location</a>)</td></tr></table><table class=\"grid\"><tr><td colspan=\"2\"><b>Type</b>: <a href=\"http://hl7.org/fhir/R4/task.html\">Task</a> (<a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-task.html\">QICore Task</a>)</td></tr></table><table class=\"grid\"><tr><td colspan=\"2\"><b>Type</b>: <a href=\"http://hl7.org/fhir/R4/organization.html\">Organization</a> (<a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a>)</td></tr></table><table class=\"grid\"><tr><td colspan=\"2\"><b>Type</b>: <a href=\"http://hl7.org/fhir/R4/practitioner.html\">Practitioner</a> (<a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-practitioner.html\">QICore Practitioner</a>)</td></tr></table><h2>Contents</h2></div>"
  },
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "cqi"
  }],
  "url" : "http://hl7.org/fhir/us/davinci-deqm/Library/library-mrp-example",
  "version" : "4.0.0",
  "name" : "DEQMLibraryMRPExample",
  "title" : "DEQM Library MRP Example",
  "status" : "active",
  "type" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/library-type",
      "code" : "module-definition"
    }]
  },
  "date" : "2023-10-03T16:11:14+00:00",
  "publisher" : "HL7 International / Clinical Quality Information",
  "contact" : [{
    "telecom" : [{
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/cqi"
    }]
  }],
  "description" : "Example Library resource to demonstrate the framework for MRP",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "US"
    }]
  }],
  "dataRequirement" : [{
    "type" : "MeasureReport",
    "profile" : ["http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/datax-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://hl7.org/fhir/us/qicore/StructureDefinition/qicore-task"]
  },
  {
    "type" : "Organization",
    "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"]
  },
  {
    "type" : "Practitioner",
    "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"]
  }]
}

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:

Figure 3-3 Submit Data Technical Workflow
MRP_Technical_Workflow.jpg

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" : "mrp-submit-task",
  "meta" : {
    "source" : "http://example.org/fhir/server"
  },
  "parameter" : [{
    "name" : "measureReport",
    "resource" : {
      "resourceType" : "MeasureReport",
      "id" : "datax-measurereport01",
      "meta" : {
        "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/cqfmeasures/StructureDefinition/cqfm-softwaresystem",
        "valueReference" : {
          "reference" : "Device/deqm-software-system-example"
        }
      },
      {
        "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/patient01"
      },
      "date" : "2018-09-05T16:59:52.404Z",
      "reporter" : {
        "reference" : "Organization/organization01"
      },
      "period" : {
        "start" : "2018-08-01",
        "end" : "2018-09-01"
      },
      "evaluatedResource" : [{
        "reference" : "Task/task01"
      }]
    }
  },
  {
    "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" : "Task",
      "id" : "Task01",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-task"]
      },
      "identifier" : [{
        "system" : "http://example.org/tasks",
        "value" : "19009"
      }],
      "status" : "completed",
      "intent" : "plan",
      "priority" : "routine",
      "code" : {
        "coding" : [{
          "system" : "http://hl7.org/fhir/CodeSystem/task-code",
          "code" : "fulfill",
          "display" : "Fulfill the focal request"
        }]
      },
      "for" : {
        "reference" : "Patient/patient01"
      },
      "encounter" : {
        "reference" : "Encounter/encounter01"
      },
      "executionPeriod" : {
        "start" : "2017-06-11",
        "end" : "2017-06-11"
      },
      "authoredOn" : "2018-09-25T14:24:23.584Z",
      "owner" : {
        "reference" : "Practitioner/practitioner01"
      }
    }
  },
  {
    "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"
      }]
    }
  }]
}

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" : "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"
      }]
    }
  }]
}

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.

Figure 3-4 Individual Reporting Technical Workflow
mrp_indv_report.jpg

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 a transaction-response Bundle is returned on successful submission.

POST Summary Report

POST [base]

Request body

{
  "resourceType" : "Bundle",
  "id" : "single-indv-mrp-task-report",
  "meta" : {
    "source" : "http://example.org/fhir/server"
  },
  "type" : "transaction",
  "timestamp" : "2019-12-06T06:28:16.152480Z",
  "entry" : [{
    "fullUrl" : "urn:uuid:97e6dbd2-17f1-11ea-82fa-4ccc6a181ed3",
    "resource" : {
      "resourceType" : "MeasureReport",
      "id" : "97e6dbd2-17f1-11ea-82fa-4ccc6a181ed3",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MeasureReport</b><a name=\"97e6dbd2-17f1-11ea-82fa-4ccc6a181ed3\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MeasureReport &quot;97e6dbd2-17f1-11ea-82fa-4ccc6a181ed3&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-indv-measurereport-deqm.html\">DEQM Individual MeasureReport Profile</a></p></div><p><b>DEQM Measure Scoring Extension</b>: Proportion <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-scoring.html\">MeasureScoring</a>#proportion)</span></p><p><b>DEQM Certification Identifier Extension</b>: id:\u00a00015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href=\"Organization-organization02.html\">Organization/organization02</a> &quot;DaVinciHospital02&quot;</p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"Measure-measure-mrp-example.html\">MRP Measure</a></p><p><b>subject</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8)</a></p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"#urnuuidebc3f5c4-6700-34af-8323-85621c313726\">See above (urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726)</a></p><p><b>period</b>: 2018-08-01 --&gt; 2018-09-01</p><p><b>improvementNotation</b>: Increased score indicates improvement <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-improvement-notation.html\">MeasureImprovementNotation</a>#increase)</span></p><blockquote><p><b>group</b></p><p><b>code</b>: MRP Group <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (#mrp-group)</span></p><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>initial-population</blockquote><p><b>code</b>: Initial Population <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#initial-population)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>numerator</blockquote><p><b>code</b>: Numerator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#numerator)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>denominator</blockquote><p><b>code</b>: Denominator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#denominator)</span></p><p><b>count</b>: 1</p></blockquote><p><b>measureScore</b>: 1</p></blockquote><p><b>evaluatedResource</b>: <a href=\"#urnuuid97e702cc-17f1-11ea-8b65-4ccc6a181ed3\">See above (urn:uuid:97e702cc-17f1-11ea-8b65-4ccc6a181ed3)</a></p></div>"
      },
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring",
        "valueCodeableConcept" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
            "code" : "proportion"
          }]
        }
      },
      {
        "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" : "Organization/organization02"
        }
      }],
      "status" : "complete",
      "type" : "individual",
      "measure" : "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
      "subject" : {
        "reference" : "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
      },
      "date" : "2018-09-05T16:59:52.404Z",
      "reporter" : {
        "reference" : "urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726"
      },
      "period" : {
        "start" : "2018-08-01",
        "end" : "2018-09-01"
      },
      "improvementNotation" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
          "code" : "increase",
          "display" : "Increased score indicates improvement"
        }]
      },
      "group" : [{
        "code" : {
          "coding" : [{
            "system" : "http://example.org/fhir/",
            "code" : "mrp-group",
            "display" : "MRP Group"
          }],
          "text" : "MRP Group"
        },
        "population" : [{
          "id" : "initial-population",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "initial-population",
              "display" : "Initial Population"
            }]
          },
          "count" : 1
        },
        {
          "id" : "numerator",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "numerator",
              "display" : "Numerator"
            }]
          },
          "count" : 1
        },
        {
          "id" : "denominator",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "denominator",
              "display" : "Denominator"
            }]
          },
          "count" : 1
        }],
        "measureScore" : {
          "value" : 1
        }
      }],
      "evaluatedResource" : [{
        "reference" : "urn:uuid:97e702cc-17f1-11ea-8b65-4ccc6a181ed3"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "MeasureReport"
    }
  },
  {
    "fullUrl" : "urn:uuid:97e702cc-17f1-11ea-8b65-4ccc6a181ed3",
    "resource" : {
      "resourceType" : "Task",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-task"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Task</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-task.html\">QICore Task</a></p></div><p><b>identifier</b>: id:\u00a019009</p><p><b>status</b>: completed</p><p><b>intent</b>: plan</p><p><b>priority</b>: routine</p><p><b>code</b>: Fulfill the focal request <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-task-code.html\">Task Codes</a>#fulfill)</span></p><p><b>for</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8)</a></p><p><b>encounter</b>: <a href=\"#urnuuid1f33ae07-0891-4c2a-a376-fcd18800cb71\">See above (urn:uuid:1f33ae07-0891-4c2a-a376-fcd18800cb71)</a></p><p><b>executionPeriod</b>: 2017-06-11 --&gt; 2017-06-11</p><p><b>authoredOn</b>: 2018-09-25 14:24:23+0000</p><p><b>owner</b>: <a href=\"#urnuuid0000016d-235f-39b3-0000-0000000000fa\">See above (urn:uuid:0000016d-235f-39b3-0000-0000000000fa)</a></p></div>"
      },
      "identifier" : [{
        "system" : "http://example.org/fhir/",
        "value" : "19009"
      }],
      "status" : "completed",
      "intent" : "plan",
      "priority" : "routine",
      "code" : {
        "coding" : [{
          "system" : "http://hl7.org/fhir/CodeSystem/task-code",
          "code" : "fulfill",
          "display" : "Fulfill the focal request"
        }]
      },
      "for" : {
        "reference" : "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
      },
      "encounter" : {
        "reference" : "urn:uuid:1f33ae07-0891-4c2a-a376-fcd18800cb71"
      },
      "executionPeriod" : {
        "start" : "2017-06-11",
        "end" : "2017-06-11"
      },
      "authoredOn" : "2018-09-25T14:24:23.584Z",
      "owner" : {
        "reference" : "urn:uuid:0000016d-235f-39b3-0000-0000000000fa"
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Task"
    }
  },
  {
    "fullUrl" : "urn:uuid:97e729ba-17f1-11ea-ae32-4ccc6a181ed3",
    "resource" : {
      "resourceType" : "Coverage",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Coverage</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-coverage.html\">QICore Coverage</a></p></div><p><b>status</b>: active</p><p><b>policyHolder</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8)</a></p><p><b>subscriber</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8)</a></p><p><b>subscriberId</b>: A123456789</p><p><b>beneficiary</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8)</a></p><p><b>relationship</b>: Self <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-subscriber-relationship.html\">SubscriberPolicyholder Relationship Codes</a>#self)</span></p><p><b>payor</b>: <a href=\"#urnuuid97e750b7-17f1-11ea-b4af-4ccc6a181ed3\">See above (urn:uuid:97e750b7-17f1-11ea-b4af-4ccc6a181ed3)</a></p></div>"
      },
      "status" : "active",
      "policyHolder" : {
        "reference" : "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
      },
      "subscriber" : {
        "reference" : "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
      },
      "subscriberId" : "A123456789",
      "beneficiary" : {
        "reference" : "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
      },
      "relationship" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
          "code" : "self"
        }]
      },
      "payor" : [{
        "reference" : "urn:uuid:97e750b7-17f1-11ea-b4af-4ccc6a181ed3"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Coverage"
    }
  },
  {
    "fullUrl" : "urn:uuid:97e750b6-17f1-11ea-89ea-4ccc6a181ed3",
    "resource" : {
      "resourceType" : "Organization",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Tax ID number: 456789124\u00a0(use:\u00a0OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: Other <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-organization-type.html\">Organization type</a>#other)</span></p><p><b>name</b>: DV Quality Measure Data Reporter</p><p><b>telecom</b>: ph: (+1) 616-555-1212</p><p><b>address</b>: 160 Glen Eagles Road Grand Rapids MI 49503 USA </p></div>"
      },
      "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" : "456789124",
        "assigner" : {
          "display" : "www.irs.gov"
        }
      }],
      "active" : true,
      "type" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
          "code" : "other",
          "display" : "Other"
        }]
      }],
      "name" : "DV Quality Measure Data Reporter",
      "telecom" : [{
        "system" : "phone",
        "value" : "(+1) 616-555-1212"
      }],
      "address" : [{
        "line" : ["160 Glen Eagles Road"],
        "city" : "Grand Rapids",
        "state" : "MI",
        "postalCode" : "49503",
        "country" : "USA"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Organization"
    }
  },
  {
    "fullUrl" : "urn:uuid:97e750b7-17f1-11ea-b4af-4ccc6a181ed3",
    "resource" : {
      "resourceType" : "Organization",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Tax ID number: 456789125\u00a0(use:\u00a0OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: Insurance Company <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-organization-type.html\">Organization type</a>#ins)</span></p><p><b>name</b>: DVPayer04</p><p><b>telecom</b>: ph: (+1) 616-555-1212</p><p><b>address</b>: 160 Glen Eagles Road Grand Rapids MI 49503 USA </p></div>"
      },
      "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" : "456789125",
        "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"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Organization"
    }
  },
  {
    "fullUrl" : "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8",
    "resource" : {
      "resourceType" : "Patient",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-patient.html\">QICore Patient</a></p></div><blockquote><p><b>US Core Race Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: White (Details: urn:oid:2.16.840.1.113883.6.238 code 2106-3 = '2106-3', stated as 'White')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: White</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: Not Hispanic or Latino (Details: urn:oid:2.16.840.1.113883.6.238 code 2186-5 = '2186-5', stated as 'Not Hispanic or Latino')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>US Core Birth Sex Extension</b>: F</p><p><b>Birth Place</b>: Faro Algarve PT </p><p><b>identifier</b>: id:\u00a00156e3a9-c4e1-4c0a-a53e-03ce3984ac65, Medical Record Number:\u00a00156e3a9-c4e1-4c0a-a53e-03ce3984ac65, Social Security Number:\u00a0999-61-8566, Driver's license Number:\u00a0S99966861, Passport Number:\u00a0X52208740X</p><p><b>name</b>: Debbie941 McDermott739 (OFFICIAL), Debbie941 Funk324 (MAIDEN)</p><p><b>telecom</b>: ph: 555-755-4280(HOME)</p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1961-02-26</p><p><b>address</b>: 903 Wolff Ville Westfield MA 01085 US </p><p><b>maritalStatus</b>: M <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-v3-MaritalStatus.html\">MaritalStatus</a>#M &quot;Married&quot;)</span></p><p><b>multipleBirth</b>: false</p><h3>Communications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Language</b></td></tr><tr><td style=\"display: none\">*</td><td>Portuguese <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-v3-ietf3066.html\">Tags for the Identification of Languages</a>#pt)</span></td></tr></table></div>"
      },
      "extension" : [{
        "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"
      },
      {
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
        "valueCode" : "F"
      },
      {
        "url" : "http://hl7.org/fhir/StructureDefinition/patient-birthPlace",
        "valueAddress" : {
          "city" : "Faro",
          "state" : "Algarve",
          "country" : "PT"
        }
      }],
      "identifier" : [{
        "system" : "https://github.com/synthetichealth/synthea",
        "value" : "0156e3a9-c4e1-4c0a-a53e-03ce3984ac65"
      },
      {
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "MR",
            "display" : "Medical Record Number"
          }],
          "text" : "Medical Record Number"
        },
        "system" : "http://hospital.smarthealthit.org",
        "value" : "0156e3a9-c4e1-4c0a-a53e-03ce3984ac65"
      },
      {
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "SS",
            "display" : "Social Security Number"
          }],
          "text" : "Social Security Number"
        },
        "system" : "http://hl7.org/fhir/sid/us-ssn",
        "value" : "999-61-8566"
      },
      {
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "DL",
            "display" : "Driver's license Number"
          }],
          "text" : "Driver's license Number"
        },
        "system" : "urn:oid:2.16.840.1.113883.4.3.25",
        "value" : "S99966861"
      },
      {
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "PPN",
            "display" : "Passport Number"
          }],
          "text" : "Passport Number"
        },
        "system" : "http://standardhealthrecord.org/fhir/StructureDefinition/passportNumber",
        "value" : "X52208740X"
      }],
      "name" : [{
        "use" : "official",
        "family" : "McDermott739",
        "given" : ["Debbie941"],
        "prefix" : ["Mrs."]
      },
      {
        "use" : "maiden",
        "family" : "Funk324",
        "given" : ["Debbie941"],
        "prefix" : ["Mrs."]
      }],
      "telecom" : [{
        "system" : "phone",
        "value" : "555-755-4280",
        "use" : "home"
      }],
      "gender" : "female",
      "birthDate" : "1961-02-26",
      "address" : [{
        "line" : ["903 Wolff Ville"],
        "city" : "Westfield",
        "state" : "MA",
        "postalCode" : "01085",
        "country" : "US"
      }],
      "maritalStatus" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
          "code" : "M",
          "display" : "Married"
        }],
        "text" : "M"
      },
      "multipleBirthBoolean" : false,
      "communication" : [{
        "language" : {
          "coding" : [{
            "system" : "urn:ietf:bcp:47",
            "code" : "pt",
            "display" : "Portuguese"
          }],
          "text" : "Portuguese"
        }
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Patient"
    }
  },
  {
    "fullUrl" : "urn:uuid:1f33ae07-0891-4c2a-a376-fcd18800cb71",
    "resource" : {
      "resourceType" : "Encounter",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Encounter</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-encounter.html\">US Core Encounter Profile</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: ambulatory (Details: http://terminology.hl7.org/CodeSystem/v3-ActCode code AMB = 'ambulatory', stated as 'null')</p><p><b>type</b>: Initial hospital care <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CPT.html\">Current Procedural Terminology (CPT®)</a>#99221 &quot;Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.&quot;)</span></p><p><b>subject</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8: Mrs. Debbie941 McDermott739)</a></p><h3>Participants</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Individual</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"#urnuuid0000016d-235f-39b3-0000-0000000000fa\">See above (urn:uuid:0000016d-235f-39b3-0000-0000000000fa: Dr. Manuel446 Granados71)</a></td></tr></table><p><b>period</b>: 1976-06-20 10:41:49-0700 --&gt; 2018-04-29 10:41:49-0700</p><h3>Locations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Location</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"#urnuuid8938e769-59f7-40ff-a541-50b0bfcd6742\">See above (urn:uuid:8938e769-59f7-40ff-a541-50b0bfcd6742: NOBLE HOSPITAL)</a></td></tr></table><p><b>serviceProvider</b>: <a href=\"#urnuuidebc3f5c4-6700-34af-8323-85621c313726\">See above (urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726: NOBLE HOSPITAL)</a></p></div>"
      },
      "status" : "finished",
      "class" : {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code" : "AMB"
      },
      "type" : [{
        "coding" : [{
          "system" : "http://www.ama-assn.org/go/cpt",
          "code" : "99221",
          "display" : "Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded."
        }],
        "text" : "Initial hospital care"
      }],
      "subject" : {
        "reference" : "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8",
        "display" : "Mrs. Debbie941 McDermott739"
      },
      "participant" : [{
        "individual" : {
          "reference" : "urn:uuid:0000016d-235f-39b3-0000-0000000000fa",
          "display" : "Dr. Manuel446 Granados71"
        }
      }],
      "period" : {
        "start" : "1976-06-20T10:41:49-07:00",
        "end" : "2018-04-29T10:41:49-07:00"
      },
      "location" : [{
        "location" : {
          "reference" : "urn:uuid:8938e769-59f7-40ff-a541-50b0bfcd6742",
          "display" : "NOBLE HOSPITAL"
        }
      }],
      "serviceProvider" : {
        "reference" : "urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726",
        "display" : "NOBLE HOSPITAL"
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Encounter"
    }
  },
  {
    "fullUrl" : "urn:uuid:0000016d-235f-39b3-0000-0000000000fa",
    "resource" : {
      "resourceType" : "Practitioner",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Practitioner</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-practitioner.html\">US Core Practitioner Profile</a></p></div><p><b>identifier</b>: id:\u00a0250</p><p><b>active</b>: true</p><p><b>name</b>: Manuel446 Granados71 </p><p><b>telecom</b>: <a href=\"mailto:Manuel446.Granados71@example.com\">Manuel446.Granados71@example.com</a></p><p><b>address</b>: 115 WEST SILVER STREET WESTFIELD MA 01085 US </p><p><b>gender</b>: male</p></div>"
      },
      "identifier" : [{
        "system" : "http://hl7.org/fhir/sid/us-npi",
        "value" : "250"
      }],
      "active" : true,
      "name" : [{
        "family" : "Granados71",
        "given" : ["Manuel446"],
        "prefix" : ["Dr."]
      }],
      "telecom" : [{
        "extension" : [{
          "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct",
          "valueBoolean" : true
        }],
        "system" : "email",
        "value" : "Manuel446.Granados71@example.com",
        "use" : "work"
      }],
      "address" : [{
        "line" : ["115 WEST SILVER STREET"],
        "city" : "WESTFIELD",
        "state" : "MA",
        "postalCode" : "01085",
        "country" : "US"
      }],
      "gender" : "male"
    },
    "request" : {
      "method" : "POST",
      "url" : "Practitioner"
    }
  },
  {
    "fullUrl" : "urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726",
    "resource" : {
      "resourceType" : "Organization",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-organization.html\">US Core Organization Profile</a></p></div><p><b>identifier</b>: Provider number: 9999999999\u00a0(use:\u00a0OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: Healthcare Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-organization-type.html\">Organization type</a>#prov)</span></p><p><b>name</b>: NOBLE HOSPITAL</p><p><b>telecom</b>: ph: 4135682811</p><p><b>address</b>: 115 WEST SILVER STREET WESTFIELD MA 01085 US </p></div>"
      },
      "identifier" : [{
        "use" : "official",
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "PRN"
          }]
        },
        "system" : "http://hl7.org/fhir/sid/us-npi",
        "value" : "9999999999"
      }],
      "active" : true,
      "type" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
          "code" : "prov",
          "display" : "Healthcare Provider"
        }],
        "text" : "Healthcare Provider"
      }],
      "name" : "NOBLE HOSPITAL",
      "telecom" : [{
        "system" : "phone",
        "value" : "4135682811"
      }],
      "address" : [{
        "line" : ["115 WEST SILVER STREET"],
        "city" : "WESTFIELD",
        "state" : "MA",
        "postalCode" : "01085",
        "country" : "US"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Organization"
    }
  },
  {
    "fullUrl" : "urn:uuid:8938e769-59f7-40ff-a541-50b0bfcd6742",
    "resource" : {
      "resourceType" : "Location",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-location"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Location</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-location.html\">US Core Location Profile</a></p></div><p><b>status</b>: active</p><p><b>name</b>: NOBLE HOSPITAL</p><p><b>telecom</b>: ph: 4135682811</p><p><b>address</b>: 115 WEST SILVER STREET WESTFIELD MA 01085 US </p><h3>Positions</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Longitude</b></td><td><b>Latitude</b></td></tr><tr><td style=\"display: none\">*</td><td>-72.755911</td><td>42.138838</td></tr></table><p><b>managingOrganization</b>: <a href=\"#urnuuidebc3f5c4-6700-34af-8323-85621c313726\">See above (urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726: NOBLE HOSPITAL)</a></p></div>"
      },
      "status" : "active",
      "name" : "NOBLE HOSPITAL",
      "telecom" : [{
        "system" : "phone",
        "value" : "4135682811"
      }],
      "address" : {
        "line" : ["115 WEST SILVER STREET"],
        "city" : "WESTFIELD",
        "state" : "MA",
        "postalCode" : "01085",
        "country" : "US"
      },
      "position" : {
        "longitude" : -72.755911,
        "latitude" : 42.138838
      },
      "managingOrganization" : {
        "reference" : "urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726",
        "display" : "NOBLE HOSPITAL"
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Location"
    }
  }]
}

Response

HTTP/1.1 200 OK
[other headers]

{
"resourceType": "Bundle",
"id": "5d9f7be3-f755-4a3e-8a05-782a1aa4943c",
"type": "transaction-response",
"link": [
{
"relation": "self",
"url": "http://hapi.fhir.org/baseR4"
}
],
"entry": [
{
"response": {
"status": "201 Created",
"location": "MeasureReport/223276/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Task/223277/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Coverage/223278/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/223279/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/223280/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Patient/223281/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Encounter/223282/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Practitioner/223283/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/223284/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Location/223285/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:21:19.522+00:00"
}
}
]
}

Examples

Scenario:

Payer X who is acting in the role of a Reporter submits a MRP Individual Reports for Patients P, Q and R 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 a transaction-response Bundle is returned on successful submission.

POST Summary Report

POST [base]

Request body

{
  "resourceType" : "Bundle",
  "id" : "multiple-indv-mrp-task-report",
  "type" : "transaction",
  "timestamp" : "2020-07-08T22:16:38.284687Z",
  "entry" : [{
    "fullUrl" : "http://example.org/fhir/receiver/Patient/patient03",
    "resource" : {
      "resourceType" : "Patient",
      "id" : "patient03",
      "meta" : {
        "versionId" : "4",
        "lastUpdated" : "2019-02-07T18:47:34.000+00:00",
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b><a name=\"patient03\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Patient &quot;patient03&quot; Version &quot;4&quot; Updated &quot;2019-02-07 18:47:34+0000&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-patient.html\">QICore Patient</a></p></div><p><b>US Core Birth Sex Extension</b>: F</p><blockquote><p><b>US Core Race Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: Black or African American (Details: urn:oid:2.16.840.1.113883.6.238 code 2054-5 = '2054-5', stated as 'Black or African American')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Black or African American</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: Not Hispanic or Latino (Details: urn:oid:2.16.840.1.113883.6.238 code 2186-5 = '2186-5', stated as 'Not Hispanic or Latino')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>identifier</b>: Medical record number: 34567\u00a0(use:\u00a0USUAL)</p><p><b>active</b>: true</p><p><b>name</b>: Virginia Hartman (OFFICIAL)</p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1983-09-12</p><p><b>deceased</b>: false</p><p><b>address</b>: 213 Lilac Ave. Freehold MI 48099 USA (HOME)</p><p><b>maritalStatus</b>: unmarried <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-v3-MaritalStatus.html\">MaritalStatus</a>#U)</span></p><h3>Communications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Language</b></td><td><b>Preferred</b></td></tr><tr><td style=\"display: none\">*</td><td>English (Region=United States) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-v3-ietf3066.html\">Tags for the Identification of Languages</a>#en-US)</span></td><td>true</td></tr></table><p><b>managingOrganization</b>: <a href=\"#Organization_organization03\">See above (Organization/organization03)</a></p></div>"
      },
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
        "valueCode" : "F"
      },
      {
        "extension" : [{
          "url" : "ombCategory",
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.6.238",
            "code" : "2054-5",
            "display" : "Black or African American"
          }
        },
        {
          "url" : "text",
          "valueString" : "Black or African American"
        }],
        "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" : "34567"
      }],
      "active" : true,
      "name" : [{
        "use" : "official",
        "family" : "Hartman",
        "given" : ["Virginia"]
      }],
      "gender" : "female",
      "birthDate" : "1983-09-12",
      "deceasedBoolean" : false,
      "address" : [{
        "use" : "home",
        "line" : ["213 Lilac Ave."],
        "city" : "Freehold",
        "state" : "MI",
        "postalCode" : "48099",
        "country" : "USA"
      }],
      "maritalStatus" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
          "code" : "U",
          "display" : "unmarried"
        }]
      },
      "communication" : [{
        "language" : {
          "coding" : [{
            "system" : "urn:ietf:bcp:47",
            "code" : "en-US",
            "display" : "English (Region=United States)"
          }]
        },
        "preferred" : true
      }],
      "managingOrganization" : {
        "reference" : "Organization/organization03"
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Patient"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Patient/patient02",
    "resource" : {
      "resourceType" : "Patient",
      "id" : "patient02",
      "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-patient"]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b><a name=\"patient02\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Patient &quot;patient02&quot; Version &quot;4&quot; Updated &quot;2019-03-06 19:03:03+0000&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-patient.html\">QICore Patient</a></p></div><p><b>US Core Birth Sex Extension</b>: M</p><blockquote><p><b>US Core Race Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: Asian (Details: urn:oid:2.16.840.1.113883.6.238 code 2028-9 = '2028-9', stated as 'Asian')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Asian</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: Not Hispanic or Latino (Details: urn:oid:2.16.840.1.113883.6.238 code 2186-5 = '2186-5', stated as 'Not Hispanic or Latino')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>identifier</b>: Medical record number: 23456\u00a0(use:\u00a0USUAL)</p><p><b>active</b>: true</p><p><b>name</b>: Darien Bernard (OFFICIAL)</p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1967-06-13</p><p><b>deceased</b>: false</p><p><b>address</b>: 6 Rockwell Street Lynnwood NJ 07420 USA (HOME)</p><p><b>maritalStatus</b>: Married <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-v3-MaritalStatus.html\">MaritalStatus</a>#M)</span></p><h3>Communications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Language</b></td><td><b>Preferred</b></td></tr><tr><td style=\"display: none\">*</td><td>English (Region=United States) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-v3-ietf3066.html\">Tags for the Identification of Languages</a>#en-US)</span></td><td>true</td></tr></table><p><b>managingOrganization</b>: <a href=\"#Organization_organization02\">See above (Organization/organization02)</a></p></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" : "2028-9",
            "display" : "Asian"
          }
        },
        {
          "url" : "text",
          "valueString" : "Asian"
        }],
        "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" : "23456"
      }],
      "active" : true,
      "name" : [{
        "use" : "official",
        "family" : "Bernard",
        "given" : ["Darien"]
      }],
      "gender" : "male",
      "birthDate" : "1967-06-13",
      "deceasedBoolean" : false,
      "address" : [{
        "use" : "home",
        "line" : ["6 Rockwell Street"],
        "city" : "Lynnwood",
        "state" : "NJ",
        "postalCode" : "07420",
        "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/organization02"
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Patient"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/MeasureReport/indv-measurereport02",
    "resource" : {
      "resourceType" : "MeasureReport",
      "id" : "indv-measurereport02",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MeasureReport</b><a name=\"indv-measurereport02\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MeasureReport &quot;indv-measurereport02&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-indv-measurereport-deqm.html\">DEQM Individual MeasureReport Profile</a></p></div><p><b>DEQM Measure Scoring Extension</b>: Proportion <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-scoring.html\">MeasureScoring</a>#proportion)</span></p><p><b>DEQM Certification Identifier Extension</b>: id:\u00a00015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href=\"#Organization_organization02\">See above (Organization/organization02)</a></p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"Measure-measure-mrp-example.html\">MRP Measure</a></p><p><b>subject</b>: <a href=\"#Patient_patient01\">See above (Patient/patient01)</a></p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"#Organization_organization01\">See above (Organization/organization01)</a></p><p><b>period</b>: 2018-08-01 --&gt; 2018-09-01</p><p><b>improvementNotation</b>: Increased score indicates improvement <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-improvement-notation.html\">MeasureImprovementNotation</a>#increase)</span></p><blockquote><p><b>group</b></p><p><b>code</b>: MRP Group <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (#mrp-group)</span></p><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>initial-population</blockquote><p><b>code</b>: Initial Population <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#initial-population)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>numerator</blockquote><p><b>code</b>: Numerator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#numerator)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>denominator</blockquote><p><b>code</b>: Denominator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#denominator)</span></p><p><b>count</b>: 1</p></blockquote><p><b>measureScore</b>: 1</p></blockquote><p><b>evaluatedResource</b>: <a href=\"#Task_task01\">See above (Task/task01)</a></p></div>"
      },
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring",
        "valueCodeableConcept" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
            "code" : "proportion"
          }]
        }
      },
      {
        "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" : "Organization/organization02"
        }
      }],
      "status" : "complete",
      "type" : "individual",
      "measure" : "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
      "subject" : {
        "reference" : "Patient/patient01"
      },
      "date" : "2018-09-05T16:59:52.404Z",
      "reporter" : {
        "reference" : "Organization/organization01"
      },
      "period" : {
        "start" : "2018-08-01",
        "end" : "2018-09-01"
      },
      "improvementNotation" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
          "code" : "increase",
          "display" : "Increased score indicates improvement"
        }]
      },
      "group" : [{
        "code" : {
          "coding" : [{
            "system" : "http://example.org/fhir/",
            "code" : "mrp-group",
            "display" : "MRP Group"
          }],
          "text" : "MRP Group"
        },
        "population" : [{
          "id" : "initial-population",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "initial-population",
              "display" : "Initial Population"
            }]
          },
          "count" : 1
        },
        {
          "id" : "numerator",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "numerator",
              "display" : "Numerator"
            }]
          },
          "count" : 1
        },
        {
          "id" : "denominator",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "denominator",
              "display" : "Denominator"
            }]
          },
          "count" : 1
        }],
        "measureScore" : {
          "value" : 1
        }
      }],
      "evaluatedResource" : [{
        "reference" : "Task/task01"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "MeasureReport"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Task/task01",
    "resource" : {
      "resourceType" : "Task",
      "id" : "task01",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-task"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Task</b><a name=\"task01\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Task &quot;task01&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-task.html\">QICore Task</a></p></div><p><b>identifier</b>: id:\u00a019009</p><p><b>status</b>: completed</p><p><b>intent</b>: plan</p><p><b>priority</b>: routine</p><p><b>code</b>: Fulfill the focal request <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-task-code.html\">Task Codes</a>#fulfill)</span></p><p><b>for</b>: <a href=\"#Patient_patient01\">See above (Patient/patient01)</a></p><p><b>encounter</b>: <a href=\"#Encounter_encounter01\">See above (Encounter/encounter01)</a></p><p><b>executionPeriod</b>: 2017-06-11 --&gt; 2017-06-11</p><p><b>authoredOn</b>: 2018-09-25 14:24:23+0000</p><p><b>owner</b>: <a href=\"#Practitioner_practitioner01\">See above (Practitioner/practitioner01)</a></p></div>"
      },
      "identifier" : [{
        "system" : "http://example.org/tasks",
        "value" : "19009"
      }],
      "status" : "completed",
      "intent" : "plan",
      "priority" : "routine",
      "code" : {
        "coding" : [{
          "system" : "http://hl7.org/fhir/CodeSystem/task-code",
          "code" : "fulfill",
          "display" : "Fulfill the focal request"
        }]
      },
      "for" : {
        "reference" : "Patient/patient01"
      },
      "encounter" : {
        "reference" : "Encounter/encounter01"
      },
      "executionPeriod" : {
        "start" : "2017-06-11",
        "end" : "2017-06-11"
      },
      "authoredOn" : "2018-09-25T14:24:23.584Z",
      "owner" : {
        "reference" : "Practitioner/practitioner01"
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Task"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Encounter/encounter03",
    "resource" : {
      "resourceType" : "Encounter",
      "id" : "encounter03",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Encounter</b><a name=\"encounter03\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Encounter &quot;encounter03&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-encounter.html\">QICore Encounter</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: inpatient encounter (Details: http://terminology.hl7.org/CodeSystem/v3-ActCode code IMP = 'inpatient encounter', stated as 'inpatient encounter')</p><p><b>type</b>: Respiratory therapy <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#53950000)</span></p><p><b>subject</b>: <a href=\"#Patient_patient03\">See above (Patient/patient03)</a></p><p><b>period</b>: 2018-05-29 11:00:00-0400 --&gt; 2018-05-29 11:00:00-0400</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>DischargeDisposition</b></td></tr><tr><td style=\"display: none\">*</td><td>Home <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-discharge-disposition.html\">Discharge disposition</a>#home)</span></td></tr></table></div>"
      },
      "status" : "finished",
      "class" : {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code" : "IMP",
        "display" : "inpatient encounter"
      },
      "type" : [{
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "53950000",
          "display" : "Respiratory therapy"
        }]
      }],
      "subject" : {
        "reference" : "Patient/patient03"
      },
      "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"
          }]
        }
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Encounter"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Patient/patient01",
    "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" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b><a name=\"patient01\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Patient &quot;patient01&quot; Version &quot;5&quot; Updated &quot;2019-02-11 14:19:25+0000&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-patient.html\">QICore Patient</a></p></div><p><b>US Core Birth Sex Extension</b>: M</p><blockquote><p><b>US Core Race Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: White (Details: urn:oid:2.16.840.1.113883.6.238 code 2106-3 = '2106-3', stated as 'White')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: White</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: Not Hispanic or Latino (Details: urn:oid:2.16.840.1.113883.6.238 code 2186-5 = '2186-5', stated as 'Not Hispanic or Latino')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>identifier</b>: Medical record number: 12345\u00a0(use:\u00a0USUAL)</p><p><b>active</b>: true</p><p><b>name</b>: Jairo Webster (OFFICIAL)</p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1946-12-16</p><p><b>deceased</b>: false</p><p><b>address</b>: 7496 Beaver Ridge Ave Thornton NJ 07003 USA (HOME)</p><p><b>maritalStatus</b>: Married <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-v3-MaritalStatus.html\">MaritalStatus</a>#M)</span></p><h3>Communications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Language</b></td><td><b>Preferred</b></td></tr><tr><td style=\"display: none\">*</td><td>English (Region=United States) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-v3-ietf3066.html\">Tags for the Identification of Languages</a>#en-US)</span></td><td>true</td></tr></table><p><b>managingOrganization</b>: <a href=\"#Organization_organization01\">See above (Organization/organization01)</a></p></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"
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Patient"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Practitioner/practitioner01",
    "resource" : {
      "resourceType" : "Practitioner",
      "id" : "practitioner01",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Practitioner</b><a name=\"practitioner01\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Practitioner &quot;practitioner01&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-practitioner.html\">QICore Practitioner</a></p></div><p><b>identifier</b>: Provider number: 345678912\u00a0(use:\u00a0OFFICIAL), Provider number: 082583\u00a0(use:\u00a0SECONDARY)</p><p><b>name</b>: Ronald Bone </p><p><b>address</b>: 1003 Healthcare Drive Amherst MA 01002 (HOME)</p></div>"
      },
      "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" : "345678912",
        "assigner" : {
          "display" : "www.cms.gov"
        }
      },
      {
        "use" : "secondary",
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "PRN",
            "display" : "Provider number"
          }]
        },
        "system" : "urn:oid:2.16.840.1.113883.4.336",
        "value" : "082583",
        "assigner" : {
          "display" : "www.cms.gov"
        }
      }],
      "name" : [{
        "family" : "Bone",
        "given" : ["Ronald"],
        "prefix" : ["Dr"]
      }],
      "address" : [{
        "use" : "home",
        "line" : ["1003 Healthcare Drive"],
        "city" : "Amherst",
        "state" : "MA",
        "postalCode" : "01002"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Practitioner"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Task/task03",
    "resource" : {
      "resourceType" : "Task",
      "id" : "task03",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-task"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Task</b><a name=\"task03\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Task &quot;task03&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-task.html\">QICore Task</a></p></div><p><b>identifier</b>: id:\u00a019011</p><p><b>status</b>: completed</p><p><b>intent</b>: plan</p><p><b>priority</b>: routine</p><p><b>code</b>: Fulfill the focal request <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-task-code.html\">Task Codes</a>#fulfill)</span></p><p><b>for</b>: <a href=\"#Patient_patient03\">See above (Patient/patient03)</a></p><p><b>encounter</b>: <a href=\"#Encounter_encounter03\">See above (Encounter/encounter03)</a></p><p><b>executionPeriod</b>: 2017-08-11 --&gt; 2017-08-11</p><p><b>authoredOn</b>: 2018-09-25 14:24:23+0000</p><p><b>owner</b>: <a href=\"Practitioner-practitioner03.html\">Practitioner/practitioner03</a> &quot; AUFDERHAR&quot;</p></div>"
      },
      "identifier" : [{
        "system" : "http://example.org/tasks",
        "value" : "19011"
      }],
      "status" : "completed",
      "intent" : "plan",
      "priority" : "routine",
      "code" : {
        "coding" : [{
          "system" : "http://hl7.org/fhir/CodeSystem/task-code",
          "code" : "fulfill",
          "display" : "Fulfill the focal request"
        }]
      },
      "for" : {
        "reference" : "Patient/patient03"
      },
      "encounter" : {
        "reference" : "Encounter/encounter03"
      },
      "executionPeriod" : {
        "start" : "2017-08-11",
        "end" : "2017-08-11"
      },
      "authoredOn" : "2018-09-25T14:24:23.584Z",
      "owner" : {
        "reference" : "Practitioner/practitioner03"
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Task"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Practitioner/practitioner02",
    "resource" : {
      "resourceType" : "Practitioner",
      "id" : "practitioner02",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Practitioner</b><a name=\"practitioner02\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Practitioner &quot;practitioner02&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-practitioner.html\">QICore Practitioner</a></p></div><p><b>identifier</b>: Provider number: 9998266512\u00a0(use:\u00a0OFFICIAL,\u00a0period:\u00a02005-07-16 09:00:00-0500 --&gt; (ongoing))</p><p><b>active</b>: true</p><p><b>name</b>: Emile Zieme(OFFICIAL)</p><p><b>telecom</b>: ph: 8605555555(WORK), ph: 8605555555(WORK)</p><p><b>address</b>: UCONN MEDICAL GROUP, FARMINGTON, CT 060300001(HOME)</p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1964-06-19</p><p><b>communication</b>: English and Spanish <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-v3-ietf3066.html\">Tags for the Identification of Languages</a>#es &quot;Spanish&quot;)</span></p></div>"
      },
      "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" : "9998266512",
        "period" : {
          "start" : "2005-07-16T09:00:00-05:00"
        },
        "assigner" : {
          "display" : "www.cms.gov"
        }
      }],
      "active" : true,
      "name" : [{
        "use" : "official",
        "text" : "Emile Zieme",
        "family" : "Zieme",
        "given" : ["Emile"],
        "suffix" : ["M.D."]
      }],
      "telecom" : [{
        "system" : "phone",
        "value" : "8605555555",
        "use" : "work",
        "rank" : 1
      },
      {
        "system" : "phone",
        "value" : "8605555555",
        "use" : "work",
        "rank" : 2
      }],
      "address" : [{
        "extension" : [{
          "extension" : [{
            "url" : "latitude",
            "valueDecimal" : 41.791776
          },
          {
            "url" : "longitude",
            "valueDecimal" : -72.718832
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/geolocation"
        }],
        "use" : "home",
        "type" : "both",
        "text" : "UCONN MEDICAL GROUP, FARMINGTON, CT 060300001",
        "line" : ["UCONN MEDICAL GROUP"],
        "city" : "FARMINGTON",
        "state" : "CT",
        "postalCode" : "060300001",
        "country" : "USA"
      }],
      "gender" : "male",
      "birthDate" : "1964-06-19",
      "communication" : [{
        "coding" : [{
          "system" : "urn:ietf:bcp:47",
          "code" : "es",
          "display" : "Spanish",
          "userSelected" : true
        }],
        "text" : "English and Spanish"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Practitioner"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Task/task02",
    "resource" : {
      "resourceType" : "Task",
      "id" : "task02",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-task"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Task</b><a name=\"task02\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Task &quot;task02&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-task.html\">QICore Task</a></p></div><p><b>identifier</b>: id:\u00a019010</p><p><b>status</b>: completed</p><p><b>intent</b>: plan</p><p><b>priority</b>: routine</p><p><b>code</b>: Fulfill the focal request <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-task-code.html\">Task Codes</a>#fulfill)</span></p><p><b>for</b>: <a href=\"#Patient_patient02\">See above (Patient/patient02)</a></p><p><b>encounter</b>: <a href=\"#Encounter_encounter02\">See above (Encounter/encounter02)</a></p><p><b>executionPeriod</b>: 2017-06-15 --&gt; 2017-06-17</p><p><b>authoredOn</b>: 2018-09-25 14:24:23+0000</p><p><b>owner</b>: <a href=\"#Practitioner_practitioner02\">See above (Practitioner/practitioner02)</a></p></div>"
      },
      "identifier" : [{
        "system" : "http://example.org/tasks",
        "value" : "19010"
      }],
      "status" : "completed",
      "intent" : "plan",
      "priority" : "routine",
      "code" : {
        "coding" : [{
          "system" : "http://hl7.org/fhir/CodeSystem/task-code",
          "code" : "fulfill",
          "display" : "Fulfill the focal request"
        }]
      },
      "for" : {
        "reference" : "Patient/patient02"
      },
      "encounter" : {
        "reference" : "Encounter/encounter02"
      },
      "executionPeriod" : {
        "start" : "2017-06-15",
        "end" : "2017-06-17"
      },
      "authoredOn" : "2018-09-25T14:24:23.584Z",
      "owner" : {
        "reference" : "Practitioner/practitioner02"
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Task"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/MeasureReport/indv-measurereport02b",
    "resource" : {
      "resourceType" : "MeasureReport",
      "id" : "indv-measurereport02b",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MeasureReport</b><a name=\"indv-measurereport02b\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MeasureReport &quot;indv-measurereport02b&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-indv-measurereport-deqm.html\">DEQM Individual MeasureReport Profile</a></p></div><p><b>DEQM Measure Scoring Extension</b>: Proportion <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-scoring.html\">MeasureScoring</a>#proportion)</span></p><p><b>DEQM Certification Identifier Extension</b>: id:\u00a00015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href=\"#Organization_organization02\">See above (Organization/organization02)</a></p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"Measure-measure-mrp-example.html\">MRP Measure</a></p><p><b>subject</b>: <a href=\"#Patient_patient03\">See above (Patient/patient03)</a></p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"#Organization_organization01\">See above (Organization/organization01)</a></p><p><b>period</b>: 2018-08-01 --&gt; 2018-09-01</p><p><b>improvementNotation</b>: Increased score indicates improvement <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-improvement-notation.html\">MeasureImprovementNotation</a>#increase)</span></p><blockquote><p><b>group</b></p><p><b>code</b>: MRP Group <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (#mrp-group)</span></p><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>initial-population</blockquote><p><b>code</b>: Initial Population <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#initial-population)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>numerator</blockquote><p><b>code</b>: Numerator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#numerator)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>denominator</blockquote><p><b>code</b>: Denominator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#denominator)</span></p><p><b>count</b>: 1</p></blockquote><p><b>measureScore</b>: 1</p></blockquote><p><b>evaluatedResource</b>: <a href=\"#Task_task03\">See above (Task/task03)</a></p></div>"
      },
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring",
        "valueCodeableConcept" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
            "code" : "proportion"
          }]
        }
      },
      {
        "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" : "Organization/organization02"
        }
      }],
      "status" : "complete",
      "type" : "individual",
      "measure" : "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
      "subject" : {
        "reference" : "Patient/patient03"
      },
      "date" : "2018-09-05T16:59:52.404Z",
      "reporter" : {
        "reference" : "Organization/organization01"
      },
      "period" : {
        "start" : "2018-08-01",
        "end" : "2018-09-01"
      },
      "improvementNotation" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
          "code" : "increase",
          "display" : "Increased score indicates improvement"
        }]
      },
      "group" : [{
        "code" : {
          "coding" : [{
            "system" : "http://example.org/fhir/",
            "code" : "mrp-group",
            "display" : "MRP Group"
          }],
          "text" : "MRP Group"
        },
        "population" : [{
          "id" : "initial-population",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "initial-population",
              "display" : "Initial Population"
            }]
          },
          "count" : 1
        },
        {
          "id" : "numerator",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "numerator",
              "display" : "Numerator"
            }]
          },
          "count" : 1
        },
        {
          "id" : "denominator",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "denominator",
              "display" : "Denominator"
            }]
          },
          "count" : 1
        }],
        "measureScore" : {
          "value" : 1
        }
      }],
      "evaluatedResource" : [{
        "reference" : "Task/task03"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "MeasureReport"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Organization/organization01",
    "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"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b><a name=\"organization01\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Organization &quot;organization01&quot; Version &quot;4&quot; Updated &quot;2019-02-21 01:47:54+0000&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Tax ID number: 123456789\u00a0(use:\u00a0OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: Healthcare Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-organization-type.html\">Organization type</a>#prov)</span></p><p><b>name</b>: DaVinciHospital01</p><p><b>telecom</b>: ph: (+1) 401-555-1212</p><p><b>address</b>: 73 Lakewood Street Warwick RI 02886 USA </p></div>"
      },
      "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"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Organization"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Encounter/encounter01",
    "resource" : {
      "resourceType" : "Encounter",
      "id" : "encounter01",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Encounter</b><a name=\"encounter01\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Encounter &quot;encounter01&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-encounter.html\">QICore Encounter</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: inpatient encounter (Details: http://terminology.hl7.org/CodeSystem/v3-ActCode code IMP = 'inpatient encounter', stated as 'inpatient encounter')</p><p><b>type</b>: Drug rehabilitation and detoxification <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#56876005)</span></p><p><b>subject</b>: <a href=\"#Patient_patient01\">See above (Patient/patient01: Jairo Webster)</a></p><p><b>period</b>: 2018-05-29 11:00:00-0400 --&gt; 2018-05-29 11:00:00-0400</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>DischargeDisposition</b></td></tr><tr><td style=\"display: none\">*</td><td>Home <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-discharge-disposition.html\">Discharge disposition</a>#home)</span></td></tr></table></div>"
      },
      "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"
          }]
        }
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Encounter"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Organization/organization02",
    "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"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b><a name=\"organization02\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Organization &quot;organization02&quot; Version &quot;3&quot; Updated &quot;2019-03-06 19:03:03+0000&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Tax ID number: 234567891\u00a0(use:\u00a0OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: Healthcare Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-organization-type.html\">Organization type</a>#prov)</span></p><p><b>name</b>: DaVinciHospital02</p><p><b>telecom</b>: ph: (+1) 551-555-1212</p><p><b>address</b>: 3 Sherwood St. Englewood NJ 07631 USA </p></div>"
      },
      "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"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Organization"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Encounter/encounter02",
    "resource" : {
      "resourceType" : "Encounter",
      "id" : "encounter02",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Encounter</b><a name=\"encounter02\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Encounter &quot;encounter02&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-encounter.html\">QICore Encounter</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: inpatient encounter (Details: http://terminology.hl7.org/CodeSystem/v3-ActCode code IMP = 'inpatient encounter', stated as 'inpatient encounter')</p><p><b>type</b>: Fixation of fracture <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#239279000)</span></p><p><b>subject</b>: <a href=\"#Patient_patient02\">See above (Patient/patient02)</a></p><p><b>period</b>: 2018-05-29 11:00:00-0400 --&gt; 2018-05-29 11:00:00-0400</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>DischargeDisposition</b></td></tr><tr><td style=\"display: none\">*</td><td>Home <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-discharge-disposition.html\">Discharge disposition</a>#home)</span></td></tr></table></div>"
      },
      "status" : "finished",
      "class" : {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code" : "IMP",
        "display" : "inpatient encounter"
      },
      "type" : [{
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "239279000",
          "display" : "Fixation of fracture"
        }]
      }],
      "subject" : {
        "reference" : "Patient/patient02"
      },
      "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"
          }]
        }
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Encounter"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/MeasureReport/indv-measurereport02a",
    "resource" : {
      "resourceType" : "MeasureReport",
      "id" : "indv-measurereport02a",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MeasureReport</b><a name=\"indv-measurereport02a\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MeasureReport &quot;indv-measurereport02a&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-indv-measurereport-deqm.html\">DEQM Individual MeasureReport Profile</a></p></div><p><b>DEQM Measure Scoring Extension</b>: Proportion <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-scoring.html\">MeasureScoring</a>#proportion)</span></p><p><b>DEQM Certification Identifier Extension</b>: id:\u00a00015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href=\"#Organization_organization02\">See above (Organization/organization02)</a></p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"Measure-measure-mrp-example.html\">MRP Measure</a></p><p><b>subject</b>: <a href=\"#Patient_patient02\">See above (Patient/patient02)</a></p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"#Organization_organization01\">See above (Organization/organization01)</a></p><p><b>period</b>: 2018-08-01 --&gt; 2018-09-01</p><p><b>improvementNotation</b>: Increased score indicates improvement <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-improvement-notation.html\">MeasureImprovementNotation</a>#increase)</span></p><blockquote><p><b>group</b></p><p><b>code</b>: MRP Group <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (#mrp-group)</span></p><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>initial-population</blockquote><p><b>code</b>: Initial Population <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#initial-population)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>numerator</blockquote><p><b>code</b>: Numerator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#numerator)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>denominator</blockquote><p><b>code</b>: Denominator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#denominator)</span></p><p><b>count</b>: 1</p></blockquote><p><b>measureScore</b>: 1</p></blockquote><p><b>evaluatedResource</b>: <a href=\"#Task_task02\">See above (Task/task02)</a></p></div>"
      },
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring",
        "valueCodeableConcept" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
            "code" : "proportion"
          }]
        }
      },
      {
        "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" : "Organization/organization02"
        }
      }],
      "status" : "complete",
      "type" : "individual",
      "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"
      },
      "improvementNotation" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
          "code" : "increase",
          "display" : "Increased score indicates improvement"
        }]
      },
      "group" : [{
        "code" : {
          "coding" : [{
            "system" : "http://example.org/fhir/",
            "code" : "mrp-group",
            "display" : "MRP Group"
          }],
          "text" : "MRP Group"
        },
        "population" : [{
          "id" : "initial-population",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "initial-population",
              "display" : "Initial Population"
            }]
          },
          "count" : 1
        },
        {
          "id" : "numerator",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "numerator",
              "display" : "Numerator"
            }]
          },
          "count" : 1
        },
        {
          "id" : "denominator",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "denominator",
              "display" : "Denominator"
            }]
          },
          "count" : 1
        }],
        "measureScore" : {
          "value" : 1
        }
      }],
      "evaluatedResource" : [{
        "reference" : "Task/task02"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "MeasureReport"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Organization/organization03",
    "resource" : {
      "resourceType" : "Organization",
      "id" : "organization03",
      "meta" : {
        "versionId" : "3",
        "lastUpdated" : "2019-02-21T01:47:53.000+00:00",
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b><a name=\"organization03\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Organization &quot;organization03&quot; Version &quot;3&quot; Updated &quot;2019-02-21 01:47:53+0000&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Provider number: 345678912\u00a0(use:\u00a0OFFICIAL), Provider number: 082584\u00a0(use:\u00a0SECONDARY)</p><p><b>active</b>: true</p><p><b>type</b>: Healthcare Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-organization-type.html\">Organization type</a>#prov)</span></p><p><b>name</b>: DaVinciHospital03</p><p><b>telecom</b>: ph: (+1) 201-555-1212</p><p><b>address</b>: 94 Olive Ave. Union City NJ 07087 USA </p></div>"
      },
      "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" : "345678912",
        "assigner" : {
          "display" : "www.cms.gov"
        }
      },
      {
        "use" : "secondary",
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "PRN",
            "display" : "Provider number"
          }]
        },
        "system" : "urn:oid:2.16.840.1.113883.4.336",
        "value" : "082584",
        "assigner" : {
          "display" : "www.cms.gov"
        }
      }],
      "active" : true,
      "type" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
          "code" : "prov",
          "display" : "Healthcare Provider"
        }]
      }],
      "name" : "DaVinciHospital03",
      "telecom" : [{
        "system" : "phone",
        "value" : "(+1) 201-555-1212"
      }],
      "address" : [{
        "line" : ["94 Olive Ave."],
        "city" : "Union City",
        "state" : "NJ",
        "postalCode" : "07087",
        "country" : "USA"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Organization"
    }
  }]
}

Response

HTTP/1.1 200 OK
[other headers]

{
"resourceType": "Bundle",
"id": "0f8c1be3-70e7-4b96-ad36-f4c408cc4e22",
"type": "transaction-response",
"link": [
{
"relation": "self",
"url": "http://hapi.fhir.org/baseR4"
}
],
"entry": [
{
"response": {
"status": "201 Created",
"location": "MeasureReport/223306/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Task/223307/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Coverage/223308/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/223309/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/223310/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "MeasureReport/223311/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Task/223312/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Coverage/223313/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "MeasureReport/223314/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Task/223315/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Coverage/223316/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Patient/223317/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Encounter/223318/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Practitioner/223319/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/223320/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Location/223321/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Patient/223322/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Encounter/223323/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Practitioner/223324/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Patient/223325/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Encounter/223326/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Practitioner/223327/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:32:06.116+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 a transaction-response Bundle is returned on successful submission.

POST Summary Report

POST [base]

Request body

{
  "resourceType" : "Bundle",
  "id" : "single-indv-mrp-obs-report",
  "meta" : {
    "source" : "http://example.org/fhir/server"
  },
  "type" : "transaction",
  "timestamp" : "2019-12-06T06:28:44.902388Z",
  "entry" : [{
    "fullUrl" : "urn:uuid:a8f9c686-17f1-11ea-a072-4ccc6a181ed3",
    "resource" : {
      "resourceType" : "MeasureReport",
      "id" : "a8f9c686-17f1-11ea-a072-4ccc6a181ed3",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MeasureReport</b><a name=\"a8f9c686-17f1-11ea-a072-4ccc6a181ed3\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MeasureReport &quot;a8f9c686-17f1-11ea-a072-4ccc6a181ed3&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-indv-measurereport-deqm.html\">DEQM Individual MeasureReport Profile</a></p></div><p><b>DEQM Measure Scoring Extension</b>: Proportion <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-scoring.html\">MeasureScoring</a>#proportion)</span></p><p><b>DEQM Certification Identifier Extension</b>: id:\u00a00015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href=\"Organization-organization02.html\">Organization/organization02</a> &quot;DaVinciHospital02&quot;</p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"Measure-measure-mrp-example.html\">MRP Measure</a></p><p><b>subject</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8)</a></p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"#urnuuidebc3f5c4-6700-34af-8323-85621c313726\">See above (urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726)</a></p><p><b>period</b>: 2018-08-01 --&gt; 2018-09-01</p><p><b>improvementNotation</b>: Increased score indicates improvement <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-improvement-notation.html\">MeasureImprovementNotation</a>#increase)</span></p><blockquote><p><b>group</b></p><p><b>code</b>: MRP Group <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (#mrp-group)</span></p><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>initial-population</blockquote><p><b>code</b>: Initial Population <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#initial-population)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>numerator</blockquote><p><b>code</b>: Numerator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#numerator)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>denominator</blockquote><p><b>code</b>: Denominator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#denominator)</span></p><p><b>count</b>: 1</p></blockquote><p><b>measureScore</b>: 1</p></blockquote><p><b>evaluatedResource</b>: <a href=\"#urnuuida8fa3b69-17f1-11ea-bd75-4ccc6a181ed3\">See above (urn:uuid:a8fa3b69-17f1-11ea-bd75-4ccc6a181ed3)</a></p></div>"
      },
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring",
        "valueCodeableConcept" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
            "code" : "proportion"
          }]
        }
      },
      {
        "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" : "Organization/organization02"
        }
      }],
      "status" : "complete",
      "type" : "individual",
      "measure" : "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
      "subject" : {
        "reference" : "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
      },
      "date" : "2018-09-05T16:59:52.404Z",
      "reporter" : {
        "reference" : "urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726"
      },
      "period" : {
        "start" : "2018-08-01",
        "end" : "2018-09-01"
      },
      "improvementNotation" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
          "code" : "increase",
          "display" : "Increased score indicates improvement"
        }]
      },
      "group" : [{
        "code" : {
          "coding" : [{
            "system" : "http://example.org/fhir/",
            "code" : "mrp-group",
            "display" : "MRP Group"
          }],
          "text" : "MRP Group"
        },
        "population" : [{
          "id" : "initial-population",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "initial-population",
              "display" : "Initial Population"
            }]
          },
          "count" : 1
        },
        {
          "id" : "numerator",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "numerator",
              "display" : "Numerator"
            }]
          },
          "count" : 1
        },
        {
          "id" : "denominator",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "denominator",
              "display" : "Denominator"
            }]
          },
          "count" : 1
        }],
        "measureScore" : {
          "value" : 1
        }
      }],
      "evaluatedResource" : [{
        "reference" : "urn:uuid:a8fa3b69-17f1-11ea-bd75-4ccc6a181ed3"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "MeasureReport"
    }
  },
  {
    "fullUrl" : "urn:uuid:a8fa147a-17f1-11ea-91ce-4ccc6a181ed3",
    "resource" : {
      "resourceType" : "Coverage",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Coverage</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-coverage.html\">QICore Coverage</a></p></div><p><b>status</b>: active</p><p><b>policyHolder</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8)</a></p><p><b>subscriber</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8)</a></p><p><b>subscriberId</b>: A123456789</p><p><b>beneficiary</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8)</a></p><p><b>relationship</b>: Self <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-subscriber-relationship.html\">SubscriberPolicyholder Relationship Codes</a>#self)</span></p><p><b>payor</b>: <a href=\"#urnuuida8fa3b68-17f1-11ea-93ae-4ccc6a181ed3\">See above (urn:uuid:a8fa3b68-17f1-11ea-93ae-4ccc6a181ed3)</a></p></div>"
      },
      "status" : "active",
      "policyHolder" : {
        "reference" : "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
      },
      "subscriber" : {
        "reference" : "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
      },
      "subscriberId" : "A123456789",
      "beneficiary" : {
        "reference" : "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
      },
      "relationship" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
          "code" : "self"
        }]
      },
      "payor" : [{
        "reference" : "urn:uuid:a8fa3b68-17f1-11ea-93ae-4ccc6a181ed3"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Coverage"
    }
  },
  {
    "fullUrl" : "urn:uuid:a8fa147b-17f1-11ea-9ba7-4ccc6a181ed3",
    "resource" : {
      "resourceType" : "Organization",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Tax ID number: 456789124\u00a0(use:\u00a0OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: Other <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-organization-type.html\">Organization type</a>#other)</span></p><p><b>name</b>: DV Quality Measure Data Reporter</p><p><b>telecom</b>: ph: (+1) 616-555-1212</p><p><b>address</b>: 160 Glen Eagles Road Grand Rapids MI 49503 USA </p></div>"
      },
      "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" : "456789124",
        "assigner" : {
          "display" : "www.irs.gov"
        }
      }],
      "active" : true,
      "type" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
          "code" : "other",
          "display" : "Other"
        }]
      }],
      "name" : "DV Quality Measure Data Reporter",
      "telecom" : [{
        "system" : "phone",
        "value" : "(+1) 616-555-1212"
      }],
      "address" : [{
        "line" : ["160 Glen Eagles Road"],
        "city" : "Grand Rapids",
        "state" : "MI",
        "postalCode" : "49503",
        "country" : "USA"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Organization"
    }
  },
  {
    "fullUrl" : "urn:uuid:a8fa3b68-17f1-11ea-93ae-4ccc6a181ed3",
    "resource" : {
      "resourceType" : "Organization",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Tax ID number: 456789125\u00a0(use:\u00a0OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: Insurance Company <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-organization-type.html\">Organization type</a>#ins)</span></p><p><b>name</b>: DVPayer04</p><p><b>telecom</b>: ph: (+1) 616-555-1212</p><p><b>address</b>: 160 Glen Eagles Road Grand Rapids MI 49503 USA </p></div>"
      },
      "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" : "456789125",
        "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"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Organization"
    }
  },
  {
    "fullUrl" : "urn:uuid:a8fa3b69-17f1-11ea-bd75-4ccc6a181ed3",
    "resource" : {
      "resourceType" : "Observation",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-observation.html\">QICore Observation</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Exam <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#exam)</span></p><p><b>code</b>: Discharge medications reconciled with the current medication list in outpatient medical record (COA) (GER) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CPT.html\">Current Procedural Terminology (CPT®)</a>#1111F)</span></p><p><b>subject</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8)</a></p><p><b>encounter</b>: <a href=\"#urnuuid1f33ae07-0891-4c2a-a376-fcd18800cb71\">See above (urn:uuid:1f33ae07-0891-4c2a-a376-fcd18800cb71)</a></p><p><b>effective</b>: 2018-09-29 14:15:04+0000</p><p><b>issued</b>: Sep 29, 2018, 2:15:04 PM</p><p><b>performer</b>: <a href=\"#urnuuid0000016d-235f-39b3-0000-0000000000fa\">See above (urn:uuid:0000016d-235f-39b3-0000-0000000000fa)</a></p><p><b>value</b>: true</p></div>"
      },
      "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" : "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8"
      },
      "encounter" : {
        "reference" : "urn:uuid:1f33ae07-0891-4c2a-a376-fcd18800cb71"
      },
      "effectiveDateTime" : "2018-09-29T14:15:04.424Z",
      "issued" : "2018-09-29T14:15:04.424Z",
      "performer" : [{
        "reference" : "urn:uuid:0000016d-235f-39b3-0000-0000000000fa"
      }],
      "valueBoolean" : true
    },
    "request" : {
      "method" : "POST",
      "url" : "Observation"
    }
  },
  {
    "fullUrl" : "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8",
    "resource" : {
      "resourceType" : "Patient",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-patient.html\">QICore Patient</a></p></div><blockquote><p><b>US Core Race Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: White (Details: urn:oid:2.16.840.1.113883.6.238 code 2106-3 = '2106-3', stated as 'White')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: White</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: Not Hispanic or Latino (Details: urn:oid:2.16.840.1.113883.6.238 code 2186-5 = '2186-5', stated as 'Not Hispanic or Latino')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>US Core Birth Sex Extension</b>: F</p><p><b>Birth Place</b>: Faro Algarve PT </p><p><b>identifier</b>: id:\u00a00156e3a9-c4e1-4c0a-a53e-03ce3984ac65, Medical Record Number:\u00a00156e3a9-c4e1-4c0a-a53e-03ce3984ac65, Social Security Number:\u00a0999-61-8566, Driver's license Number:\u00a0S99966861, Passport Number:\u00a0X52208740X</p><p><b>name</b>: Debbie941 McDermott739 (OFFICIAL), Debbie941 Funk324 (MAIDEN)</p><p><b>telecom</b>: ph: 555-755-4280(HOME)</p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1961-02-26</p><p><b>address</b>: 903 Wolff Ville Westfield MA 01085 US </p><p><b>maritalStatus</b>: M <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-v3-MaritalStatus.html\">MaritalStatus</a>#M &quot;Married&quot;)</span></p><p><b>multipleBirth</b>: false</p><h3>Communications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Language</b></td></tr><tr><td style=\"display: none\">*</td><td>Portuguese <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-v3-ietf3066.html\">Tags for the Identification of Languages</a>#pt)</span></td></tr></table></div>"
      },
      "extension" : [{
        "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"
      },
      {
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
        "valueCode" : "F"
      },
      {
        "url" : "http://hl7.org/fhir/StructureDefinition/patient-birthPlace",
        "valueAddress" : {
          "city" : "Faro",
          "state" : "Algarve",
          "country" : "PT"
        }
      }],
      "identifier" : [{
        "system" : "https://github.com/synthetichealth/synthea",
        "value" : "0156e3a9-c4e1-4c0a-a53e-03ce3984ac65"
      },
      {
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "MR",
            "display" : "Medical Record Number"
          }],
          "text" : "Medical Record Number"
        },
        "system" : "http://hospital.smarthealthit.org",
        "value" : "0156e3a9-c4e1-4c0a-a53e-03ce3984ac65"
      },
      {
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "SS",
            "display" : "Social Security Number"
          }],
          "text" : "Social Security Number"
        },
        "system" : "http://hl7.org/fhir/sid/us-ssn",
        "value" : "999-61-8566"
      },
      {
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "DL",
            "display" : "Driver's license Number"
          }],
          "text" : "Driver's license Number"
        },
        "system" : "urn:oid:2.16.840.1.113883.4.3.25",
        "value" : "S99966861"
      },
      {
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "PPN",
            "display" : "Passport Number"
          }],
          "text" : "Passport Number"
        },
        "system" : "http://standardhealthrecord.org/fhir/StructureDefinition/passportNumber",
        "value" : "X52208740X"
      }],
      "name" : [{
        "use" : "official",
        "family" : "McDermott739",
        "given" : ["Debbie941"],
        "prefix" : ["Mrs."]
      },
      {
        "use" : "maiden",
        "family" : "Funk324",
        "given" : ["Debbie941"],
        "prefix" : ["Mrs."]
      }],
      "telecom" : [{
        "system" : "phone",
        "value" : "555-755-4280",
        "use" : "home"
      }],
      "gender" : "female",
      "birthDate" : "1961-02-26",
      "address" : [{
        "line" : ["903 Wolff Ville"],
        "city" : "Westfield",
        "state" : "MA",
        "postalCode" : "01085",
        "country" : "US"
      }],
      "maritalStatus" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
          "code" : "M",
          "display" : "Married"
        }],
        "text" : "M"
      },
      "multipleBirthBoolean" : false,
      "communication" : [{
        "language" : {
          "coding" : [{
            "system" : "urn:ietf:bcp:47",
            "code" : "pt",
            "display" : "Portuguese"
          }],
          "text" : "Portuguese"
        }
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Patient"
    }
  },
  {
    "fullUrl" : "urn:uuid:1f33ae07-0891-4c2a-a376-fcd18800cb71",
    "resource" : {
      "resourceType" : "Encounter",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Encounter</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-encounter.html\">QICore Encounter</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: ambulatory (Details: http://terminology.hl7.org/CodeSystem/v3-ActCode code AMB = 'ambulatory', stated as 'null')</p><p><b>type</b>: Initial hospital care <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CPT.html\">Current Procedural Terminology (CPT®)</a>#99221 &quot;Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.&quot;)</span></p><p><b>subject</b>: <a href=\"#urnuuid6f0cef31-2235-4d66-82e2-fa861fc909a8\">See above (urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8: Mrs. Debbie941 McDermott739)</a></p><h3>Participants</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Individual</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"#urnuuid0000016d-235f-39b3-0000-0000000000fa\">See above (urn:uuid:0000016d-235f-39b3-0000-0000000000fa: Dr. Manuel446 Granados71)</a></td></tr></table><p><b>period</b>: 1976-06-20 10:41:49-0700 --&gt; 2018-04-29 10:41:49-0700</p><h3>Locations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Location</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"#urnuuid8938e769-59f7-40ff-a541-50b0bfcd6742\">See above (urn:uuid:8938e769-59f7-40ff-a541-50b0bfcd6742: NOBLE HOSPITAL)</a></td></tr></table><p><b>serviceProvider</b>: <a href=\"#urnuuidebc3f5c4-6700-34af-8323-85621c313726\">See above (urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726: NOBLE HOSPITAL)</a></p></div>"
      },
      "status" : "finished",
      "class" : {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code" : "AMB"
      },
      "type" : [{
        "coding" : [{
          "system" : "http://www.ama-assn.org/go/cpt",
          "code" : "99221",
          "display" : "Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded."
        }],
        "text" : "Initial hospital care"
      }],
      "subject" : {
        "reference" : "urn:uuid:6f0cef31-2235-4d66-82e2-fa861fc909a8",
        "display" : "Mrs. Debbie941 McDermott739"
      },
      "participant" : [{
        "individual" : {
          "reference" : "urn:uuid:0000016d-235f-39b3-0000-0000000000fa",
          "display" : "Dr. Manuel446 Granados71"
        }
      }],
      "period" : {
        "start" : "1976-06-20T10:41:49-07:00",
        "end" : "2018-04-29T10:41:49-07:00"
      },
      "location" : [{
        "location" : {
          "reference" : "urn:uuid:8938e769-59f7-40ff-a541-50b0bfcd6742",
          "display" : "NOBLE HOSPITAL"
        }
      }],
      "serviceProvider" : {
        "reference" : "urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726",
        "display" : "NOBLE HOSPITAL"
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Encounter"
    }
  },
  {
    "fullUrl" : "urn:uuid:0000016d-235f-39b3-0000-0000000000fa",
    "resource" : {
      "resourceType" : "Practitioner",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Practitioner</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-practitioner.html\">US Core Practitioner Profile</a></p></div><p><b>identifier</b>: id:\u00a0250</p><p><b>active</b>: true</p><p><b>name</b>: Manuel446 Granados71 </p><p><b>telecom</b>: <a href=\"mailto:Manuel446.Granados71@example.com\">Manuel446.Granados71@example.com</a></p><p><b>address</b>: 115 WEST SILVER STREET WESTFIELD MA 01085 US </p><p><b>gender</b>: male</p></div>"
      },
      "identifier" : [{
        "system" : "http://hl7.org/fhir/sid/us-npi",
        "value" : "250"
      }],
      "active" : true,
      "name" : [{
        "family" : "Granados71",
        "given" : ["Manuel446"],
        "prefix" : ["Dr."]
      }],
      "telecom" : [{
        "extension" : [{
          "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct",
          "valueBoolean" : true
        }],
        "system" : "email",
        "value" : "Manuel446.Granados71@example.com",
        "use" : "work"
      }],
      "address" : [{
        "line" : ["115 WEST SILVER STREET"],
        "city" : "WESTFIELD",
        "state" : "MA",
        "postalCode" : "01085",
        "country" : "US"
      }],
      "gender" : "male"
    },
    "request" : {
      "method" : "POST",
      "url" : "Practitioner"
    }
  },
  {
    "fullUrl" : "urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726",
    "resource" : {
      "resourceType" : "Organization",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-organization.html\">US Core Organization Profile</a></p></div><p><b>identifier</b>: Provider number: 9999999999\u00a0(use:\u00a0OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: Healthcare Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-organization-type.html\">Organization type</a>#prov)</span></p><p><b>name</b>: NOBLE HOSPITAL</p><p><b>telecom</b>: ph: 4135682811</p><p><b>address</b>: 115 WEST SILVER STREET WESTFIELD MA 01085 US </p></div>"
      },
      "identifier" : [{
        "use" : "official",
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "PRN"
          }]
        },
        "system" : "http://hl7.org/fhir/sid/us-npi",
        "value" : "9999999999"
      }],
      "active" : true,
      "type" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
          "code" : "prov",
          "display" : "Healthcare Provider"
        }],
        "text" : "Healthcare Provider"
      }],
      "name" : "NOBLE HOSPITAL",
      "telecom" : [{
        "system" : "phone",
        "value" : "4135682811"
      }],
      "address" : [{
        "line" : ["115 WEST SILVER STREET"],
        "city" : "WESTFIELD",
        "state" : "MA",
        "postalCode" : "01085",
        "country" : "US"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Organization"
    }
  },
  {
    "fullUrl" : "urn:uuid:8938e769-59f7-40ff-a541-50b0bfcd6742",
    "resource" : {
      "resourceType" : "Location",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Location</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-location.html\">QICore Location</a></p></div><p><b>identifier</b>: id:\u00a0NOBLE HOSPITAL\u00a0(use:\u00a0TEMP)</p><p><b>status</b>: active</p><p><b>name</b>: NOBLE HOSPITAL</p><p><b>telecom</b>: ph: 4135682811</p><p><b>address</b>: 115 WEST SILVER STREET WESTFIELD MA 01085 US </p><h3>Positions</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Longitude</b></td><td><b>Latitude</b></td></tr><tr><td style=\"display: none\">*</td><td>-72.755911</td><td>42.138838</td></tr></table><p><b>managingOrganization</b>: <a href=\"#urnuuidebc3f5c4-6700-34af-8323-85621c313726\">See above (urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726: NOBLE HOSPITAL)</a></p></div>"
      },
      "identifier" : [{
        "use" : "temp",
        "system" : "http://exampleoflocation.com",
        "value" : "NOBLE HOSPITAL"
      }],
      "status" : "active",
      "name" : "NOBLE HOSPITAL",
      "telecom" : [{
        "system" : "phone",
        "value" : "4135682811"
      }],
      "address" : {
        "line" : ["115 WEST SILVER STREET"],
        "city" : "WESTFIELD",
        "state" : "MA",
        "postalCode" : "01085",
        "country" : "US"
      },
      "position" : {
        "longitude" : -72.755911,
        "latitude" : 42.138838
      },
      "managingOrganization" : {
        "reference" : "urn:uuid:ebc3f5c4-6700-34af-8323-85621c313726",
        "display" : "NOBLE HOSPITAL"
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Location"
    }
  }]
}

Response

HTTP/1.1 200 OK
[other headers]

{
"resourceType": "Bundle",
"id": "acb38f7f-2fcc-4b74-b46b-2af1c20854dc",
"type": "transaction-response",
"link": [
{
"relation": "self",
"url": "http://hapi.fhir.org/baseR4"
}
],
"entry": [
{
"response": {
"status": "201 Created",
"location": "MeasureReport/224761/_history/1",
"etag": "1",
"lastModified": "2019-12-07T01:30:03.058+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/224762/_history/1",
"etag": "1",
"lastModified": "2019-12-07T01:30:03.058+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Patient/224763/_history/1",
"etag": "1",
"lastModified": "2019-12-07T01:30:03.058+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Practitioner/224764/_history/1",
"etag": "1",
"lastModified": "2019-12-07T01:30:03.058+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Observation/224765/_history/1",
"etag": "1",
"lastModified": "2019-12-07T01:30:03.058+00:00"
}
}
]
}

Examples

Scenario:

Payer X who is acting in the role of a Reporter submits a MRP Individual Reports for Patients P, Q and R 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 a transaction-response Bundle is returned on successful submission.

POST Summary Report

POST [base]

Request body

{
  "resourceType" : "Bundle",
  "id" : "multiple-indv-mrp-obs-report",
  "type" : "transaction",
  "timestamp" : "2020-07-08T22:17:14.187160Z",
  "entry" : [{
    "fullUrl" : "http://example.org/fhir/receiver/Observation/observation03",
    "resource" : {
      "resourceType" : "Observation",
      "id" : "observation03",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"observation03\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation &quot;observation03&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-observation.html\">QICore Observation</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Exam <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#exam)</span></p><p><b>code</b>: Discharge medications reconciled with the current medication list in outpatient medical record (COA) (GER) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CPT.html\">Current Procedural Terminology (CPT®)</a>#1111F)</span></p><p><b>subject</b>: <a href=\"#Patient_patient03\">See above (Patient/patient03)</a></p><p><b>encounter</b>: <a href=\"#Encounter_encounter03\">See above (Encounter/encounter03)</a></p><p><b>effective</b>: 2018-09-30 14:15:04+0000</p><p><b>issued</b>: Sep 30, 2018, 2:15:04 PM</p><p><b>performer</b>: <a href=\"#Practitioner_practitioner02\">See above (Practitioner/practitioner02)</a></p><p><b>value</b>: true</p></div>"
      },
      "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/patient03"
      },
      "encounter" : {
        "reference" : "Encounter/encounter03"
      },
      "effectiveDateTime" : "2018-09-30T14:15:04.424Z",
      "issued" : "2018-09-30T14:15:04.424Z",
      "performer" : [{
        "reference" : "Practitioner/practitioner02"
      }],
      "valueBoolean" : true
    },
    "request" : {
      "method" : "POST",
      "url" : "Observation"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Encounter/encounter02",
    "resource" : {
      "resourceType" : "Encounter",
      "id" : "encounter02",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Encounter</b><a name=\"encounter02\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Encounter &quot;encounter02&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-encounter.html\">QICore Encounter</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: inpatient encounter (Details: http://terminology.hl7.org/CodeSystem/v3-ActCode code IMP = 'inpatient encounter', stated as 'inpatient encounter')</p><p><b>type</b>: Fixation of fracture <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#239279000)</span></p><p><b>subject</b>: <a href=\"#Patient_patient02\">See above (Patient/patient02)</a></p><p><b>period</b>: 2018-05-29 --&gt; 2018-05-29</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>DischargeDisposition</b></td></tr><tr><td style=\"display: none\">*</td><td>Home <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-discharge-disposition.html\">Discharge disposition</a>#home)</span></td></tr></table></div>"
      },
      "status" : "finished",
      "class" : {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code" : "IMP",
        "display" : "inpatient encounter"
      },
      "type" : [{
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "239279000",
          "display" : "Fixation of fracture"
        }]
      }],
      "subject" : {
        "reference" : "Patient/patient02"
      },
      "period" : {
        "start" : "2018-05-29",
        "end" : "2018-05-29"
      },
      "hospitalization" : {
        "dischargeDisposition" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/discharge-disposition",
            "code" : "home",
            "display" : "Home"
          }]
        }
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Encounter"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Organization/organization02",
    "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"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b><a name=\"organization02\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Organization &quot;organization02&quot; Version &quot;3&quot; Updated &quot;2019-03-06 19:03:03+0000&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Tax ID number: 234567891\u00a0(use:\u00a0OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: Healthcare Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-organization-type.html\">Organization type</a>#prov)</span></p><p><b>name</b>: DaVinciHospital02</p><p><b>telecom</b>: ph: (+1) 551-555-1212</p><p><b>address</b>: 3 Sherwood St. Englewood NJ 07631 USA </p></div>"
      },
      "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"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Organization"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Practitioner/practitioner02",
    "resource" : {
      "resourceType" : "Practitioner",
      "id" : "practitioner02",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Practitioner</b><a name=\"practitioner02\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Practitioner &quot;practitioner02&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-practitioner.html\">QICore Practitioner</a></p></div><p><b>identifier</b>: Provider number: 9998266512\u00a0(use:\u00a0OFFICIAL,\u00a0period:\u00a02005-07-16 09:00:00-0500 --&gt; (ongoing))</p><p><b>active</b>: true</p><p><b>name</b>: Emile Zieme(OFFICIAL)</p><p><b>telecom</b>: ph: 8605555555(WORK), ph: 8605555555(WORK)</p><p><b>address</b>: UCONN MEDICAL GROUP, FARMINGTON, CT 060300001(HOME)</p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1964-06-19</p></div>"
      },
      "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" : "9998266512",
        "period" : {
          "start" : "2005-07-16T09:00:00-05:00"
        },
        "assigner" : {
          "display" : "www.cms.gov"
        }
      }],
      "active" : true,
      "name" : [{
        "use" : "official",
        "text" : "Emile Zieme",
        "family" : "Zieme",
        "given" : ["Emile"],
        "suffix" : ["M.D."]
      }],
      "telecom" : [{
        "system" : "phone",
        "value" : "8605555555",
        "use" : "work",
        "rank" : 1
      },
      {
        "system" : "phone",
        "value" : "8605555555",
        "use" : "work",
        "rank" : 2
      }],
      "address" : [{
        "extension" : [{
          "extension" : [{
            "url" : "latitude",
            "valueDecimal" : 41.791776
          },
          {
            "url" : "longitude",
            "valueDecimal" : -72.718832
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/geolocation"
        }],
        "use" : "home",
        "type" : "both",
        "text" : "UCONN MEDICAL GROUP, FARMINGTON, CT 060300001",
        "line" : ["UCONN MEDICAL GROUP"],
        "city" : "FARMINGTON",
        "state" : "CT",
        "postalCode" : "060300001",
        "country" : "USA"
      }],
      "gender" : "male",
      "birthDate" : "1964-06-19"
    },
    "request" : {
      "method" : "POST",
      "url" : "Practitioner"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Organization/organization03",
    "resource" : {
      "resourceType" : "Organization",
      "id" : "organization03",
      "meta" : {
        "versionId" : "3",
        "lastUpdated" : "2019-02-21T01:47:53.000+00:00",
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b><a name=\"organization03\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Organization &quot;organization03&quot; Version &quot;3&quot; Updated &quot;2019-02-21 01:47:53+0000&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Provider number: 345678912\u00a0(use:\u00a0OFFICIAL), Provider number: 082584\u00a0(use:\u00a0SECONDARY)</p><p><b>active</b>: true</p><p><b>type</b>: Healthcare Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-organization-type.html\">Organization type</a>#prov)</span></p><p><b>name</b>: DaVinciHospital03</p><p><b>telecom</b>: ph: (+1) 201-555-1212</p><p><b>address</b>: 94 Olive Ave. Union City NJ 07087 USA </p></div>"
      },
      "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" : "345678912",
        "assigner" : {
          "display" : "www.cms.gov"
        }
      },
      {
        "use" : "secondary",
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "PRN",
            "display" : "Provider number"
          }]
        },
        "system" : "urn:oid:2.16.840.1.113883.4.336",
        "value" : "082584",
        "assigner" : {
          "display" : "www.cms.gov"
        }
      }],
      "active" : true,
      "type" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
          "code" : "prov",
          "display" : "Healthcare Provider"
        }]
      }],
      "name" : "DaVinciHospital03",
      "telecom" : [{
        "system" : "phone",
        "value" : "(+1) 201-555-1212"
      }],
      "address" : [{
        "line" : ["94 Olive Ave."],
        "city" : "Union City",
        "state" : "NJ",
        "postalCode" : "07087",
        "country" : "USA"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Organization"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Practitioner/practitioner01",
    "resource" : {
      "resourceType" : "Practitioner",
      "id" : "practitioner01",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Practitioner</b><a name=\"practitioner01\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Practitioner &quot;practitioner01&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-practitioner.html\">QICore Practitioner</a></p></div><p><b>identifier</b>: Provider number: 345678912\u00a0(use:\u00a0OFFICIAL), Provider number: 082583\u00a0(use:\u00a0SECONDARY)</p><p><b>name</b>: Ronald Bone </p><p><b>address</b>: 1003 Healthcare Drive Amherst MA 01002 (HOME)</p></div>"
      },
      "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" : "345678912",
        "assigner" : {
          "display" : "www.cms.gov"
        }
      },
      {
        "use" : "secondary",
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "PRN",
            "display" : "Provider number"
          }]
        },
        "system" : "urn:oid:2.16.840.1.113883.4.336",
        "value" : "082583",
        "assigner" : {
          "display" : "www.cms.gov"
        }
      }],
      "name" : [{
        "family" : "Bone",
        "given" : ["Ronald"],
        "prefix" : ["Dr"]
      }],
      "address" : [{
        "use" : "home",
        "line" : ["1003 Healthcare Drive"],
        "city" : "Amherst",
        "state" : "MA",
        "postalCode" : "01002"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Practitioner"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Patient/patient03",
    "resource" : {
      "resourceType" : "Patient",
      "id" : "patient03",
      "meta" : {
        "versionId" : "4",
        "lastUpdated" : "2019-02-07T18:47:34.000+00:00",
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b><a name=\"patient03\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Patient &quot;patient03&quot; Version &quot;4&quot; Updated &quot;2019-02-07 18:47:34+0000&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-patient.html\">QICore Patient</a></p></div><p><b>US Core Birth Sex Extension</b>: F</p><blockquote><p><b>US Core Race Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: Black or African American (Details: urn:oid:2.16.840.1.113883.6.238 code 2054-5 = '2054-5', stated as 'Black or African American')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Black or African American</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: Not Hispanic or Latino (Details: urn:oid:2.16.840.1.113883.6.238 code 2186-5 = '2186-5', stated as 'Not Hispanic or Latino')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>identifier</b>: Medical record number: 34567\u00a0(use:\u00a0USUAL)</p><p><b>active</b>: true</p><p><b>name</b>: Virginia Hartman (OFFICIAL)</p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1983-09-12</p><p><b>deceased</b>: false</p><p><b>address</b>: 213 Lilac Ave. Freehold MI 48099 USA (HOME)</p><p><b>maritalStatus</b>: unmarried <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-v3-MaritalStatus.html\">MaritalStatus</a>#U)</span></p><h3>Communications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Language</b></td><td><b>Preferred</b></td></tr><tr><td style=\"display: none\">*</td><td>English (Region=United States) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-v3-ietf3066.html\">Tags for the Identification of Languages</a>#en-US)</span></td><td>true</td></tr></table><p><b>managingOrganization</b>: <a href=\"#Organization_organization03\">See above (Organization/organization03)</a></p></div>"
      },
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
        "valueCode" : "F"
      },
      {
        "extension" : [{
          "url" : "ombCategory",
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.6.238",
            "code" : "2054-5",
            "display" : "Black or African American"
          }
        },
        {
          "url" : "text",
          "valueString" : "Black or African American"
        }],
        "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" : "34567"
      }],
      "active" : true,
      "name" : [{
        "use" : "official",
        "family" : "Hartman",
        "given" : ["Virginia"]
      }],
      "gender" : "female",
      "birthDate" : "1983-09-12",
      "deceasedBoolean" : false,
      "address" : [{
        "use" : "home",
        "line" : ["213 Lilac Ave."],
        "city" : "Freehold",
        "state" : "MI",
        "postalCode" : "48099",
        "country" : "USA"
      }],
      "maritalStatus" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
          "code" : "U",
          "display" : "unmarried"
        }]
      },
      "communication" : [{
        "language" : {
          "coding" : [{
            "system" : "urn:ietf:bcp:47",
            "code" : "en-US",
            "display" : "English (Region=United States)"
          }]
        },
        "preferred" : true
      }],
      "managingOrganization" : {
        "reference" : "Organization/organization03"
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Patient"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Encounter/encounter03",
    "resource" : {
      "resourceType" : "Encounter",
      "id" : "encounter03",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Encounter</b><a name=\"encounter03\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Encounter &quot;encounter03&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-encounter.html\">QICore Encounter</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: inpatient encounter (Details: http://terminology.hl7.org/CodeSystem/v3-ActCode code IMP = 'inpatient encounter', stated as 'inpatient encounter')</p><p><b>type</b>: Respiratory therapy <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#53950000)</span></p><p><b>subject</b>: <a href=\"#Patient_patient03\">See above (Patient/patient03)</a></p><p><b>period</b>: 2018-05-29 11:00:00-0400 --&gt; 2018-05-29 11:00:00-0400</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>DischargeDisposition</b></td></tr><tr><td style=\"display: none\">*</td><td>Home <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-discharge-disposition.html\">Discharge disposition</a>#home)</span></td></tr></table></div>"
      },
      "status" : "finished",
      "class" : {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code" : "IMP",
        "display" : "inpatient encounter"
      },
      "type" : [{
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "53950000",
          "display" : "Respiratory therapy"
        }]
      }],
      "subject" : {
        "reference" : "Patient/patient03"
      },
      "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"
          }]
        }
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Encounter"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/MeasureReport/indv-measurereport02a",
    "resource" : {
      "resourceType" : "MeasureReport",
      "id" : "indv-measurereport02a",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MeasureReport</b><a name=\"indv-measurereport02a\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MeasureReport &quot;indv-measurereport02a&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-indv-measurereport-deqm.html\">DEQM Individual MeasureReport Profile</a></p></div><p><b>DEQM Measure Scoring Extension</b>: Proportion <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-scoring.html\">MeasureScoring</a>#proportion)</span></p><p><b>DEQM Certification Identifier Extension</b>: id:\u00a00015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href=\"#Organization_organization02\">See above (Organization/organization02)</a></p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"Measure-measure-mrp-example.html\">MRP Measure</a></p><p><b>subject</b>: <a href=\"#Patient_patient02\">See above (Patient/patient02)</a></p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"#Organization_organization01\">See above (Organization/organization01)</a></p><p><b>period</b>: 2018-08-01 --&gt; 2018-09-01</p><p><b>improvementNotation</b>: Increased score indicates improvement <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-improvement-notation.html\">MeasureImprovementNotation</a>#increase)</span></p><blockquote><p><b>group</b></p><p><b>code</b>: MRP Group <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (#mrp-group)</span></p><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>initial-population</blockquote><p><b>code</b>: Initial Population <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#initial-population)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>numerator</blockquote><p><b>code</b>: Numerator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#numerator)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>denominator</blockquote><p><b>code</b>: Denominator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#denominator)</span></p><p><b>count</b>: 1</p></blockquote><p><b>measureScore</b>: 1</p></blockquote><p><b>evaluatedResource</b>: <a href=\"#Observation_observation02\">See above (Observation/observation02)</a></p></div>"
      },
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring",
        "valueCodeableConcept" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
            "code" : "proportion"
          }]
        }
      },
      {
        "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" : "Organization/organization02"
        }
      }],
      "status" : "complete",
      "type" : "individual",
      "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"
      },
      "improvementNotation" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
          "code" : "increase",
          "display" : "Increased score indicates improvement"
        }]
      },
      "group" : [{
        "code" : {
          "coding" : [{
            "system" : "http://example.org/fhir/",
            "code" : "mrp-group",
            "display" : "MRP Group"
          }],
          "text" : "MRP Group"
        },
        "population" : [{
          "id" : "initial-population",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "initial-population",
              "display" : "Initial Population"
            }]
          },
          "count" : 1
        },
        {
          "id" : "numerator",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "numerator",
              "display" : "Numerator"
            }]
          },
          "count" : 1
        },
        {
          "id" : "denominator",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "denominator",
              "display" : "Denominator"
            }]
          },
          "count" : 1
        }],
        "measureScore" : {
          "value" : 1
        }
      }],
      "evaluatedResource" : [{
        "reference" : "Observation/observation02"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "MeasureReport"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Observation/observation02",
    "resource" : {
      "resourceType" : "Observation",
      "id" : "observation02",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"observation02\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation &quot;observation02&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-observation.html\">QICore Observation</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Exam <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#exam)</span></p><p><b>code</b>: Discharge medications reconciled with the current medication list in outpatient medical record (COA) (GER) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CPT.html\">Current Procedural Terminology (CPT®)</a>#1111F)</span></p><p><b>subject</b>: <a href=\"#Patient_patient02\">See above (Patient/patient02)</a></p><p><b>encounter</b>: <a href=\"#Encounter_encounter02\">See above (Encounter/encounter02)</a></p><p><b>effective</b>: 2018-09-30 14:15:04+0000</p><p><b>issued</b>: Sep 30, 2018, 2:15:04 PM</p><p><b>performer</b>: <a href=\"#Practitioner_practitioner02\">See above (Practitioner/practitioner02)</a></p><p><b>value</b>: true</p></div>"
      },
      "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/patient02"
      },
      "encounter" : {
        "reference" : "Encounter/encounter02"
      },
      "effectiveDateTime" : "2018-09-30T14:15:04.424Z",
      "issued" : "2018-09-30T14:15:04.424Z",
      "performer" : [{
        "reference" : "Practitioner/practitioner02"
      }],
      "valueBoolean" : true
    },
    "request" : {
      "method" : "POST",
      "url" : "Observation"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/MeasureReport/indv-measurereport02",
    "resource" : {
      "resourceType" : "MeasureReport",
      "id" : "indv-measurereport02",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MeasureReport</b><a name=\"indv-measurereport02\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MeasureReport &quot;indv-measurereport02&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-indv-measurereport-deqm.html\">DEQM Individual MeasureReport Profile</a></p></div><p><b>DEQM Measure Scoring Extension</b>: Proportion <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-scoring.html\">MeasureScoring</a>#proportion)</span></p><p><b>DEQM Certification Identifier Extension</b>: id:\u00a00015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href=\"#Organization_organization02\">See above (Organization/organization02)</a></p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"Measure-measure-mrp-example.html\">MRP Measure</a></p><p><b>subject</b>: <a href=\"#Patient_patient01\">See above (Patient/patient01)</a></p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"#Organization_organization01\">See above (Organization/organization01)</a></p><p><b>period</b>: 2018-08-01 --&gt; 2018-09-01</p><p><b>improvementNotation</b>: Increased score indicates improvement <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-improvement-notation.html\">MeasureImprovementNotation</a>#increase)</span></p><blockquote><p><b>group</b></p><p><b>code</b>: MRP Group <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (#mrp-group)</span></p><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>initial-population</blockquote><p><b>code</b>: Initial Population <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#initial-population)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>numerator</blockquote><p><b>code</b>: Numerator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#numerator)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>denominator</blockquote><p><b>code</b>: Denominator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#denominator)</span></p><p><b>count</b>: 1</p></blockquote><p><b>measureScore</b>: 1</p></blockquote><p><b>evaluatedResource</b>: <a href=\"#Observation_observation01\">See above (Observation/observation01)</a></p></div>"
      },
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring",
        "valueCodeableConcept" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
            "code" : "proportion"
          }]
        }
      },
      {
        "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" : "Organization/organization02"
        }
      }],
      "status" : "complete",
      "type" : "individual",
      "measure" : "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
      "subject" : {
        "reference" : "Patient/patient01"
      },
      "date" : "2018-09-05T16:59:52.404Z",
      "reporter" : {
        "reference" : "Organization/organization01"
      },
      "period" : {
        "start" : "2018-08-01",
        "end" : "2018-09-01"
      },
      "improvementNotation" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
          "code" : "increase",
          "display" : "Increased score indicates improvement"
        }]
      },
      "group" : [{
        "code" : {
          "coding" : [{
            "system" : "http://example.org/fhir/",
            "code" : "mrp-group",
            "display" : "MRP Group"
          }],
          "text" : "MRP Group"
        },
        "population" : [{
          "id" : "initial-population",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "initial-population",
              "display" : "Initial Population"
            }]
          },
          "count" : 1
        },
        {
          "id" : "numerator",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "numerator",
              "display" : "Numerator"
            }]
          },
          "count" : 1
        },
        {
          "id" : "denominator",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "denominator",
              "display" : "Denominator"
            }]
          },
          "count" : 1
        }],
        "measureScore" : {
          "value" : 1
        }
      }],
      "evaluatedResource" : [{
        "reference" : "Observation/observation01"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "MeasureReport"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Organization/organization01",
    "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"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b><a name=\"organization01\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Organization &quot;organization01&quot; Version &quot;4&quot; Updated &quot;2019-02-21 01:47:54+0000&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Tax ID number: 123456789\u00a0(use:\u00a0OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: Healthcare Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-organization-type.html\">Organization type</a>#prov)</span></p><p><b>name</b>: DaVinciHospital01</p><p><b>telecom</b>: ph: (+1) 401-555-1212</p><p><b>address</b>: 73 Lakewood Street Warwick RI 02886 USA </p></div>"
      },
      "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"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Organization"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/MeasureReport/indv-measurereport02b",
    "resource" : {
      "resourceType" : "MeasureReport",
      "id" : "indv-measurereport02b",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm"]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MeasureReport</b><a name=\"indv-measurereport02b\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MeasureReport &quot;indv-measurereport02b&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-indv-measurereport-deqm.html\">DEQM Individual MeasureReport Profile</a></p></div><p><b>DEQM Measure Scoring Extension</b>: Proportion <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-scoring.html\">MeasureScoring</a>#proportion)</span></p><p><b>DEQM Certification Identifier Extension</b>: id:\u00a00015HQN9BD3304E</p><p><b>DEQM Reporting Vendor Extension</b>: <a href=\"#Organization_organization02\">See above (Organization/organization02)</a></p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"Measure-measure-mrp-example.html\">MRP Measure</a></p><p><b>subject</b>: <a href=\"#Patient_patient03\">See above (Patient/patient03)</a></p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"#Organization_organization01\">See above (Organization/organization01)</a></p><p><b>period</b>: 2018-08-01 --&gt; 2018-09-01</p><p><b>improvementNotation</b>: Increased score indicates improvement <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-improvement-notation.html\">MeasureImprovementNotation</a>#increase)</span></p><blockquote><p><b>group</b></p><p><b>code</b>: MRP Group <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (#mrp-group)</span></p><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>initial-population</blockquote><p><b>code</b>: Initial Population <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#initial-population)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>numerator</blockquote><p><b>code</b>: Numerator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#numerator)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>denominator</blockquote><p><b>code</b>: Denominator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#denominator)</span></p><p><b>count</b>: 1</p></blockquote><p><b>measureScore</b>: 1</p></blockquote><p><b>evaluatedResource</b>: <a href=\"#Observation_observation03\">See above (Observation/observation03)</a></p></div>"
      },
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring",
        "valueCodeableConcept" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
            "code" : "proportion"
          }]
        }
      },
      {
        "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" : "Organization/organization02"
        }
      }],
      "status" : "complete",
      "type" : "individual",
      "measure" : "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
      "subject" : {
        "reference" : "Patient/patient03"
      },
      "date" : "2018-09-05T16:59:52.404Z",
      "reporter" : {
        "reference" : "Organization/organization01"
      },
      "period" : {
        "start" : "2018-08-01",
        "end" : "2018-09-01"
      },
      "improvementNotation" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
          "code" : "increase",
          "display" : "Increased score indicates improvement"
        }]
      },
      "group" : [{
        "code" : {
          "coding" : [{
            "system" : "http://example.org/fhir/",
            "code" : "mrp-group",
            "display" : "MRP Group"
          }],
          "text" : "MRP Group"
        },
        "population" : [{
          "id" : "initial-population",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "initial-population",
              "display" : "Initial Population"
            }]
          },
          "count" : 1
        },
        {
          "id" : "numerator",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "numerator",
              "display" : "Numerator"
            }]
          },
          "count" : 1
        },
        {
          "id" : "denominator",
          "code" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
              "code" : "denominator",
              "display" : "Denominator"
            }]
          },
          "count" : 1
        }],
        "measureScore" : {
          "value" : 1
        }
      }],
      "evaluatedResource" : [{
        "reference" : "Observation/observation03"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "MeasureReport"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Encounter/encounter01",
    "resource" : {
      "resourceType" : "Encounter",
      "id" : "encounter01",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Encounter</b><a name=\"encounter01\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Encounter &quot;encounter01&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-encounter.html\">QICore Encounter</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: inpatient encounter (Details: http://terminology.hl7.org/CodeSystem/v3-ActCode code IMP = 'inpatient encounter', stated as 'inpatient encounter')</p><p><b>type</b>: Drug rehabilitation and detoxification <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#56876005)</span></p><p><b>subject</b>: <a href=\"#Patient_patient01\">See above (Patient/patient01: Jairo Webster)</a></p><p><b>period</b>: 2018-05-29 11:00:00-0400 --&gt; 2018-05-29 11:00:00-0400</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>DischargeDisposition</b></td></tr><tr><td style=\"display: none\">*</td><td>Home <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-discharge-disposition.html\">Discharge disposition</a>#home)</span></td></tr></table></div>"
      },
      "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"
          }]
        }
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Encounter"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Observation/observation01",
    "resource" : {
      "resourceType" : "Observation",
      "id" : "observation01",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : ["http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"observation01\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation &quot;observation01&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-observation.html\">QICore Observation</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Exam <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#exam)</span></p><p><b>code</b>: Discharge medications reconciled with the current medication list in outpatient medical record (COA) (GER) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-CPT.html\">Current Procedural Terminology (CPT®)</a>#1111F)</span></p><p><b>subject</b>: <a href=\"#Patient_patient01\">See above (Patient/patient01)</a></p><p><b>encounter</b>: <a href=\"#Encounter_encounter01\">See above (Encounter/encounter01)</a></p><p><b>effective</b>: 2018-09-29 14:15:04+0000</p><p><b>issued</b>: Sep 29, 2018, 2:15:04 PM</p><p><b>performer</b>: <a href=\"#Practitioner_practitioner01\">See above (Practitioner/practitioner01)</a></p><p><b>value</b>: true</p></div>"
      },
      "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
    },
    "request" : {
      "method" : "POST",
      "url" : "Observation"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Patient/patient01",
    "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" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b><a name=\"patient01\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Patient &quot;patient01&quot; Version &quot;5&quot; Updated &quot;2019-02-11 14:19:25+0000&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-patient.html\">QICore Patient</a></p></div><p><b>US Core Birth Sex Extension</b>: M</p><blockquote><p><b>US Core Race Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: White (Details: urn:oid:2.16.840.1.113883.6.238 code 2106-3 = '2106-3', stated as 'White')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: White</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: Not Hispanic or Latino (Details: urn:oid:2.16.840.1.113883.6.238 code 2186-5 = '2186-5', stated as 'Not Hispanic or Latino')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>identifier</b>: Medical record number: 12345\u00a0(use:\u00a0USUAL)</p><p><b>active</b>: true</p><p><b>name</b>: Jairo Webster (OFFICIAL)</p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1946-12-16</p><p><b>deceased</b>: false</p><p><b>address</b>: 7496 Beaver Ridge Ave Thornton NJ 07003 USA (HOME)</p><p><b>maritalStatus</b>: Married <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-v3-MaritalStatus.html\">MaritalStatus</a>#M)</span></p><h3>Communications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Language</b></td><td><b>Preferred</b></td></tr><tr><td style=\"display: none\">*</td><td>English (Region=United States) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-v3-ietf3066.html\">Tags for the Identification of Languages</a>#en-US)</span></td><td>true</td></tr></table><p><b>managingOrganization</b>: <a href=\"#Organization_organization01\">See above (Organization/organization01)</a></p></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"
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Patient"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/receiver/Patient/patient02",
    "resource" : {
      "resourceType" : "Patient",
      "id" : "patient02",
      "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-patient"]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b><a name=\"patient02\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Patient &quot;patient02&quot; Version &quot;4&quot; Updated &quot;2019-03-06 19:03:03+0000&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-patient.html\">QICore Patient</a></p></div><p><b>US Core Birth Sex Extension</b>: M</p><blockquote><p><b>US Core Race Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: Asian (Details: urn:oid:2.16.840.1.113883.6.238 code 2028-9 = '2028-9', stated as 'Asian')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Asian</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: Not Hispanic or Latino (Details: urn:oid:2.16.840.1.113883.6.238 code 2186-5 = '2186-5', stated as 'Not Hispanic or Latino')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>identifier</b>: Medical record number: 23456\u00a0(use:\u00a0USUAL)</p><p><b>active</b>: true</p><p><b>name</b>: Darien Bernard (OFFICIAL)</p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1967-06-13</p><p><b>deceased</b>: false</p><p><b>address</b>: 6 Rockwell Street Lynnwood NJ 07420 USA (HOME)</p><p><b>maritalStatus</b>: Married <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-v3-MaritalStatus.html\">MaritalStatus</a>#M)</span></p><h3>Communications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Language</b></td><td><b>Preferred</b></td></tr><tr><td style=\"display: none\">*</td><td>English (Region=United States) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-v3-ietf3066.html\">Tags for the Identification of Languages</a>#en-US)</span></td><td>true</td></tr></table><p><b>managingOrganization</b>: <a href=\"#Organization_organization02\">See above (Organization/organization02)</a></p></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" : "2028-9",
            "display" : "Asian"
          }
        },
        {
          "url" : "text",
          "valueString" : "Asian"
        }],
        "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" : "23456"
      }],
      "active" : true,
      "name" : [{
        "use" : "official",
        "family" : "Bernard",
        "given" : ["Darien"]
      }],
      "gender" : "male",
      "birthDate" : "1967-06-13",
      "deceasedBoolean" : false,
      "address" : [{
        "use" : "home",
        "line" : ["6 Rockwell Street"],
        "city" : "Lynnwood",
        "state" : "NJ",
        "postalCode" : "07420",
        "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/organization02"
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Patient"
    }
  }]
}

Response

HTTP/1.1 200 OK
[other headers]

{
"resourceType": "Bundle",
"id": "0b04c784-5983-4358-992f-7cd95a1cec05",
"type": "transaction-response",
"link": [
{
"relation": "self",
"url": "http://hapi.fhir.org/baseR4"
}
],
"entry": [
{
"response": {
"status": "201 Created",
"location": "MeasureReport/223377/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Coverage/223378/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/223379/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/223380/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Observation/223381/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "MeasureReport/223382/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Coverage/223383/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Observation/223384/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "MeasureReport/223385/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Coverage/223386/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Observation/223387/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Patient/223388/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Encounter/223389/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Practitioner/223390/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Organization/223391/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Location/223392/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Patient/223393/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Encounter/223394/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Practitioner/223395/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Patient/223396/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Encounter/223397/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
},
{
"response": {
"status": "201 Created",
"location": "Practitioner/223398/_history/1",
"etag": "1",
"lastModified": "2019-12-06T09:34:14.739+00:00"
}
}
]
}

Summary MeasureReport

The Payer (“Aggregator”) pushes the MRP Summary MeasureReport to the Receiver.

Figure 3-5 Summary Reporting Technical Workflow
mrp_summ_report.jpg

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" : {
    "source" : "http://example.org/fhir/server",
    "profile" : ["http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/summary-measurereport-deqm"]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MeasureReport</b><a name=\"summ-measurereport01\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MeasureReport &quot;summ-measurereport01&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-summary-measurereport-deqm.html\">DEQM Summary MeasureReport Profile</a></p></div><p><b>DEQM Measure Scoring Extension</b>: Proportion <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-scoring.html\">MeasureScoring</a>#proportion)</span></p><p><b>status</b>: complete</p><p><b>type</b>: summary</p><p><b>measure</b>: <a href=\"Measure-measure-mrp-example.html\">MRP Measure</a></p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"Organization-organization01.html\">Organization/organization01</a> &quot;DaVinciHospital01&quot;</p><p><b>period</b>: 2018-08-01 --&gt; 2018-09-01</p><p><b>improvementNotation</b>: Increased score indicates improvement <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-improvement-notation.html\">MeasureImprovementNotation</a>#increase)</span></p><blockquote><p><b>group</b></p><p><b>code</b>: MRP Group <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (#mrp-group)</span></p><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>initial-population</blockquote><p><b>code</b>: Initial Population <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#initial-population)</span></p><p><b>count</b>: 100</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>numerator</blockquote><p><b>code</b>: Numerator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#numerator)</span></p><p><b>count</b>: 80</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>denominator</blockquote><p><b>code</b>: Denominator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.2.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#denominator)</span></p><p><b>count</b>: 100</p></blockquote><p><b>measureScore</b>: 0.8</p></blockquote></div>"
  },
  "extension" : [{
    "url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring",
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
        "code" : "proportion"
      }]
    }
  }],
  "status" : "complete",
  "type" : "summary",
  "measure" : "http://hl7.org/fhir/us/davinci-deqm/Measure/measure-mrp-example",
  "date" : "2018-09-05T16:59:52.404Z",
  "reporter" : {
    "extension" : [{
      "url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-reporterGroup",
      "valueReference" : {
        "reference" : "Group/group01"
      }
    }],
    "reference" : "Organization/organization01"
  },
  "period" : {
    "start" : "2018-08-01",
    "end" : "2018-09-01"
  },
  "improvementNotation" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
      "code" : "increase",
      "display" : "Increased score indicates improvement"
    }]
  },
  "group" : [{
    "code" : {
      "coding" : [{
        "system" : "http://example.org/fhir/",
        "code" : "mrp-group",
        "display" : "MRP Group"
      }],
      "text" : "MRP Group"
    },
    "population" : [{
      "id" : "initial-population",
      "code" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
          "code" : "initial-population",
          "display" : "Initial Population"
        }]
      },
      "count" : 100
    },
    {
      "id" : "numerator",
      "code" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
          "code" : "numerator",
          "display" : "Numerator"
        }]
      },
      "count" : 80
    },
    {
      "id" : "denominator",
      "code" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
          "code" : "denominator",
          "display" : "Denominator"
        }]
      },
      "count" : 100
    }],
    "measureScore" : {
      "value" : 0.8
    }
  }]
}

Response

HTTP/1.1 200 OK
[other headers]

  1. Changes to QI Core and US Core Organization profiles are being proposed based on the DEQM Organization profile that may lead to this profiles being replaced by the QI Core profile.