Da Vinci - Documentation Templates and Rules
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This page is part of the Documentation Templates and Rules (v2.1.0-preview: QA Preview) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.1. For a full list of available versions, see the Directory of published versions

Logical Model: DTRMetricData - Detailed Descriptions

Page standards status: Informative Maturity Level: 1

Definitions for the DTRMetricData logical model.

Guidance on how to interpret the contents of this table can be found here

0. DTRMetricData
Definition

A logical model describing the information that should be captured by DTR implementers about every DTR invocation to support measures evaluating DTR implementation.

ShortDTR Metric Data
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. DTRMetricData.source
Definition

A code to indicate which type of system collected the metric data (DTRApp can be either a Native or SMART on FHIR app)

Shortprovider-src | payer-src | DTRApp-src
Control1..1
BindingThe codes SHALL be taken from Metric Source
(required to http://hl7.org/fhir/us/davinci-dtr/ValueSet/metric-Source)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
4. DTRMetricData.sofApp
Definition

The URL of SMART on FHIR application to identify the specific DTR application used by the provider and payer. If not present, then the DTR session is with a Full EHR.

ShortURL of SMART on FHIR application
Control0..1
Typeurl
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
6. DTRMetricData.providerId
Definition

The NPI number of the user who initiated this DTR session.

ShortIdentifier for the user initiating DTR
Control1..1
TypeIdentifier
8. DTRMetricData.providerId.system
Control1..?
Pattern Valuehttp://hl7.org/fhir/sid/us-npi
10. DTRMetricData.providerId.value
Control1..?
12. DTRMetricData.groupId
Definition

The NPI of the hospital/clinic/other organization that initiated this DTR session.

ShortIdentifier for the healthcare organization initiating DTR
Control1..1
TypeIdentifier
14. DTRMetricData.groupId.system
Control1..?
Pattern Valuehttp://hl7.org/fhir/sid/us-npi
16. DTRMetricData.groupId.value
Control1..?
18. DTRMetricData.payerId
Definition

The identifier of the payer organization supplying the questionnaire bundle for this session.

ShortPayer receiving DTR request
Control1..1
TypeIdentifier
20. DTRMetricData.payerId.system
Control1..?
22. DTRMetricData.payerId.value
Control1..?
24. DTRMetricData.assertionId
Definition

Assertion ids passed in on the coverage-information in Requests, Encounters, or QuestionnaireResponses used as context to launch DTR (or selected by the user as context post-launch) as well as passed as a Task questionnaire launch context parameter.

ShortUnique ID for order item
Comments

If there are multiple coverage-information extensions in context, this will be the union of distinct assertionIds.

Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Requirements

Allows linking DTR sessions to CRD, CDex, and potentially prior DTR sessions.

26. DTRMetricData.docReason
Definition

doc-purpose passed in on the coverage-information in Requests, Encounters or QuestoinnaireResponses used as context to launch DTR (or selected by the user as context post-launch).

Shortwithpa | withclaim | withorder | retain-doc | OTH
Comments

If there were multiple coverage-informations present in the launch context, this will be the union of distinct codes present.

Control0..*
BindingThe codes SHALL be taken from CRD Coverage Information Documentation Reason Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/DocReason)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
28. DTRMetricData.launchMode
Definition

Indicates the launch mode involved for this session.

Shortcrdlaunch | relaunch | salaunch | cdexlaunch
Control0..1
BindingThe codes SHALL be taken from Metric Launch Mode
(required to http://hl7.org/fhir/us/davinci-dtr/ValueSet/metric-launchmode)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
30. DTRMetricData.orderItem
Definition

The specific procedure, item, medication, appointment, nutrition that is the subject of the order/appointment.

ShortWhat was ordered
Control1..*
BindingUnless not suitable, these codes SHALL be taken from CRD Order Detail Codes Value Set
(extensible to http://hl7.org/fhir/us/davinci-crd/ValueSet/orderDetail)
TypeCodeableConcept
32. DTRMetricData.action
Definition

Actions performed between a system and the DTR application.

ShortActions the reporting system engaged in as part of the DTR session.
Comments

See notes section below for how the action elements should be populated for different actions

Control1..*
TypeBackboneElement
34. DTRMetricData.action.actionDetail
Definition

What type of action occurred within the DTR session.

Shortlaunch | qpackage | mrquery | userresponse | nextq | storeqr
Control1..1
BindingThe codes SHALL be taken from Metric Action
(required to http://hl7.org/fhir/us/davinci-dtr/ValueSet/metric-Action)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
36. DTRMetricData.action.requestTime
Definition

The time stamp when the action was initiated from the perspective of the reporting system.

ShortTime action initiated
Control1..1
Typeinstant
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
38. DTRMetricData.action.responseTime
Definition

The time stamp when the action was completed (including error return) from the perspective of the reporting system.

ShortTime of action response
Control0..1
Typeinstant
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
40. DTRMetricData.action.httpResponse
Definition

The HTTP response status code associated with the action (successful or not).

ShortHTTP response status code
Comments

Must be present unless action is a userresponse

Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
42. DTRMetricData.action.questionnaire
Definition

The questionnaire(s) tied to the current action

ShortAssociated Questionnaire
Control0..1
Typecanonical(DTR Standard Questionnaire, DTR Questionnaire for adaptive form)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
44. DTRMetricData.action.issue
Definition

If an OperationOutcome is returned, what were the issues?

ShortOperationOutcome info
Control0..*
TypeBackboneElement
46. DTRMetricData.action.issue.code
Definition

The issue.code value from the OperationOutcome for this issue.

ShortError code
Control1..1
BindingThe codes SHALL be taken from IssueType
(required to http://hl7.org/fhir/ValueSet/issue-type)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
48. DTRMetricData.action.issue.details
Definition

The issue.details value from the OperationOutcome for this issue.

ShortMore detailed error code
Control0..1
BindingFor example codes, see OperationOutcomeCodes
(example to http://hl7.org/fhir/ValueSet/operation-outcome)
TypeCodeableConcept
50. DTRMetricData.resources
Definition

Information that was accessed from the EHR by the one or more of the questionnaires using CQL.

ShortResource types accessed
Control0..*
TypeBackboneElement
52. DTRMetricData.resources.type
Definition

What kind of resource was accessed.

ShortKind of resource
Control1..1
BindingThe codes SHALL be taken from ResourceType
(required to http://hl7.org/fhir/ValueSet/resource-types)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
54. DTRMetricData.resources.profile
Definition

Indicates the sub-type of data accessed in situations where multiple US-core profiles could apply (e.g., Observation). Note: This does not mean that the data received was actually valid against the profile, merely that the search criteria used were intended to retrieve data of this type.

ShortSolicited profile
Control0..1
Typecanonical(StructureDefinition)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
56. DTRMetricData.resources.count
Definition

How many resources of that type were accessed.

ShortNumber retrieved
Control1..1
TypepositiveInt
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
58. DTRMetricData.questionnaire
Definition

Questionnaire that was returned in the Questionnaire package (and information about what was done with it)

ShortQuestionnaire
Control0..*
TypeBackboneElement
60. DTRMetricData.questionnaire.reference
Definition

This is the URL for the canonical questionnaire that was returned by the $questionnaire-package operation

ShortThis is the URL for the canonical questionnaire
Control1..1
Typecanonical(DTR Standard Questionnaire, DTR Questionnaire for adaptive form)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
62. DTRMetricData.questionnaire.adaptive
Definition

If the Questionnaire is an adaptive form, the value is True.

ShortTrue if adaptive form
Control0..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Meaning if MissingQuestionnaire was a standard (non-adaptive) Questionnaire
64. DTRMetricData.questionnaire.populated
Definition

If true, indicates that the draft QuestionnaireResponse provided in the Questionnaire package Bundle included at least some answers pre-populated with payer data.

ShortWhether a pre-populated response was provided from payer
Control0..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Meaning if MissingNo population occurred
66. DTRMetricData.questionnaire.failure
Definition

A failure reported to the payer about Questionnaire content using the $log-questionnaire-errors operation.

ShortQuestionnaire errors logged to payer
Control0..*
BindingThe codes SHALL be taken from IssueType
(required to http://hl7.org/fhir/ValueSet/issue-type)
TypeCodeableConcept
68. DTRMetricData.questionnaire.reviewPrior
Definition

If the provider reviewed the QuestionnaireResponse answers prior to marking it as complete or saving it in the EHR.

ShortTrue if user reviewed answers prior to final save
Control0..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Meaning if MissingUser did not review the QuestionnaireRepsonse in this session
70. DTRMetricData.questionnaire.enabledQuestions
Definition

The count of all questions enabled in the Questionnaire at the time it was marked 'complete'.

ShortNumber of enabled questions
Comments

This element is a count of the number of enabled question items at the time the QuestionnaireResponse was last stored as part of this DTR session

Control0..1
TypepositiveInt
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
72. DTRMetricData.questionnaire.autoPopulated
Definition

The count of all questions that were auto-populated from the patient's medical record and/or by payer information.

ShortNumber of questions autopopulated
Comments

The modification may have happened in a prior session. This element is a count of the number of enabled question items with an information-origin extension of 'auto' or 'override' at the time the QuestionnaireResponse was last stored as part of this DTR session.

Control0..1
TypepositiveInt
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Meaning if MissingNo questions had their answers auto-populated
74. DTRMetricData.questionnaire.roleInteraction
Definition

A summary of the information-origin extensions for all enabled questions in the Questionnaire as they were at the time the QuestionnaireResponse was last stored within the DTR session reflecting human intervention.

ShortRole specific interactions
Control0..*
TypeBackboneElement
76. DTRMetricData.questionnaire.roleInteraction.role
Definition

The type of humanrole whose questionnaire completion is summarized here. Corresponds to the information-origin.author.role. NOTE: if a form is edited by multiple people with the same roles, the items they edit or override will be aggregated together.

ShortRole of information contributor
Control1..1
BindingUnless not suitable, these codes SHALL be taken from US Core Provider Role (NUCC)
(extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role)
TypeCodeableConcept
78. DTRMetricData.questionnaire.roleInteraction.roleAction
Definition

This will indicate the type of human intervention action being summarized (auto, override or manual).

Shortoverride | manual
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Information Human Origins Value Set
(extensible to http://hl7.org/fhir/us/davinci-dtr/ValueSet/MetricsinformationOrigins)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
80. DTRMetricData.questionnaire.roleInteraction.count
Definition

This is the sum of enabled questions for the specified with an information-origin of that source AND an author.role that matches the specified role.

ShortCount of combination of role and roleInteraction
Control1..1
TypepositiveInt
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
82. DTRMetricData.questionnaire.elapsedTime
Definition

cumulative time from DTR start to QR store, including from multiple sessions.

ShortCumulative user response time that questionnaire was active in session
Control1..1
Typetime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
84. DTRMetricData.coverageInfo
Definition

Coverage information extensions returned as part of completed adaptive Questionnaires within this DTR session.

ShortCoverage information
Control0..*
TypeBackboneElement
86. DTRMetricData.coverageInfo.covered
Definition

Indicates whether the service is covered.

Shortcovered | not-covered | conditional
Control0..1
BindingThe codes SHALL be taken from CRD Coverage Information Covered Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageInfo)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
88. DTRMetricData.coverageInfo.paNeeded
Definition

Indicates whether prior authorization is necessary or not, as well as considerations about applying for prior authorization.

Shortauth-needed | no-auth | satisfied | performpa | conditional
Control0..1
BindingThe codes SHALL be taken from CRD Coverage Information Prior Authorization Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/coveragePaDetail)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
90. DTRMetricData.coverageInfo.docNeeded
Definition

Indicates whether additional information is necessary (for prior auth, claims submission, or some other purpose).

Shortclinical | admin | both | conditional
Control0..1
BindingThe codes SHALL be taken from CRD Coverage Information Additional Documentation Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/AdditionalDocumentation)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
92. DTRMetricData.coverageInfo.infoNeeded
Definition

Indicates what additional inforamtion is necessary in order to determine authorization/coverage - which might be available on a later hook invocation.

Shortperformer | location | timeframe | OTH
Control0..1
BindingThe codes SHALL be taken from CRD Information Needed Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/informationNeeded)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
94. DTRMetricData.coverageInfo.questionnaire
Definition

Information about the Questionnaire(s) returned to gather additional information (e.g. through DTR).

ShortQuestionnaire(s) returned
Control0..*
TypeBackboneElement
Requirements

Allows linking metadata about forms identified 'to be filled out' in CRD with what is actually completed in DTR, and eventually submitted in CDex, PAS or claims

96. DTRMetricData.coverageInfo.questionnaire.reference
Definition

The official identifier of one of the Questionnaires provided to be filled out.

ShortQuestionnaire url & version
Control1..1
Typecanonical(Questionnaire)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
98. DTRMetricData.coverageInfo.questionnaire.adaptive
Definition

If true, indicates that the questionnaire is adaptive (i.e. uses the $next-question operation to determine questions).

ShortIs questionnaire adaptive?
Control1..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
100. DTRMetricData.coverageInfo.questionnaire.response
Definition

If true, indicates that the card included a partially populated QuestionnaireResponse with answers filled by the payer from pre-known data.

ShortPre-pop response provided?
Control1..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
102. DTRMetricData.coverageInfo.assertionId
Definition

Corresponds to the coverage-assertion-id from the coverage-information extension.

ShortId for coverage assertion
Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Requirements

Used to link the results of CRD to metric information captured for DTR and/or PAS.

104. DTRMetricData.coverageInfo.satisfiedId
Definition

Corresponds to the satisfied-pa-id from the coverage-information extension.

ShortId if PA is satisfied
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
106. DTRMetricData.coverageInfo.businessLine
Definition

A code that indicates which type of insurance this assertion applies to.

ShortE.g. MedicareAdvantage
Control0..1
TypeCodeableConcept

Guidance on how to interpret the contents of this table can be found here

0. DTRMetricData
Definition

A logical model describing the information that should be captured by DTR implementers about every DTR invocation to support measures evaluating DTR implementation.

ShortDTR Metric Data
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. DTRMetricData.source
Definition

A code to indicate which type of system collected the metric data (DTRApp can be either a Native or SMART on FHIR app)

Shortprovider-src | payer-src | DTRApp-src
Control1..1
BindingThe codes SHALL be taken from Metric Source
(required to http://hl7.org/fhir/us/davinci-dtr/ValueSet/metric-Source)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
4. DTRMetricData.sofApp
Definition

The URL of SMART on FHIR application to identify the specific DTR application used by the provider and payer. If not present, then the DTR session is with a Full EHR.

ShortURL of SMART on FHIR application
Control0..1
Typeurl
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
6. DTRMetricData.providerId
Definition

The NPI number of the user who initiated this DTR session.

ShortIdentifier for the user initiating DTR
Control1..1
TypeIdentifier
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. DTRMetricData.providerId.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. DTRMetricData.providerId.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control10..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Pattern Valuehttp://hl7.org/fhir/sid/us-npi
Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. DTRMetricData.providerId.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. DTRMetricData.groupId
Definition

The NPI of the hospital/clinic/other organization that initiated this DTR session.

ShortIdentifier for the healthcare organization initiating DTR
Control1..1
TypeIdentifier
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. DTRMetricData.groupId.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. DTRMetricData.groupId.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control10..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Pattern Valuehttp://hl7.org/fhir/sid/us-npi
Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. DTRMetricData.groupId.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. DTRMetricData.payerId
Definition

The identifier of the payer organization supplying the questionnaire bundle for this session.

ShortPayer receiving DTR request
Control1..1
TypeIdentifier
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. DTRMetricData.payerId.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. DTRMetricData.payerId.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control10..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. DTRMetricData.payerId.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. DTRMetricData.assertionId
Definition

Assertion ids passed in on the coverage-information in Requests, Encounters, or QuestionnaireResponses used as context to launch DTR (or selected by the user as context post-launch) as well as passed as a Task questionnaire launch context parameter.

ShortUnique ID for order item
Comments

If there are multiple coverage-information extensions in context, this will be the union of distinct assertionIds.

Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Requirements

Allows linking DTR sessions to CRD, CDex, and potentially prior DTR sessions.

32. DTRMetricData.docReason
Definition

doc-purpose passed in on the coverage-information in Requests, Encounters or QuestoinnaireResponses used as context to launch DTR (or selected by the user as context post-launch).

Shortwithpa | withclaim | withorder | retain-doc | OTH
Comments

If there were multiple coverage-informations present in the launch context, this will be the union of distinct codes present.

Control0..*
BindingThe codes SHALL be taken from CRD Coverage Information Documentation Reason Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/DocReason)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
34. DTRMetricData.launchMode
Definition

Indicates the launch mode involved for this session.

Shortcrdlaunch | relaunch | salaunch | cdexlaunch
Control0..1
BindingThe codes SHALL be taken from Metric Launch Mode
(required to http://hl7.org/fhir/us/davinci-dtr/ValueSet/metric-launchmode)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
36. DTRMetricData.orderItem
Definition

The specific procedure, item, medication, appointment, nutrition that is the subject of the order/appointment.

ShortWhat was ordered
Control1..*
BindingUnless not suitable, these codes SHALL be taken from CRD Order Detail Codes Value Set
(extensible to http://hl7.org/fhir/us/davinci-crd/ValueSet/orderDetail)
TypeCodeableConcept
38. DTRMetricData.action
Definition

Actions performed between a system and the DTR application.

ShortActions the reporting system engaged in as part of the DTR session.
Comments

See notes section below for how the action elements should be populated for different actions

Control1..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. DTRMetricData.action.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
42. DTRMetricData.action.actionDetail
Definition

What type of action occurred within the DTR session.

Shortlaunch | qpackage | mrquery | userresponse | nextq | storeqr
Control1..1
BindingThe codes SHALL be taken from Metric Action
(required to http://hl7.org/fhir/us/davinci-dtr/ValueSet/metric-Action)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
44. DTRMetricData.action.requestTime
Definition

The time stamp when the action was initiated from the perspective of the reporting system.

ShortTime action initiated
Control1..1
Typeinstant
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
46. DTRMetricData.action.responseTime
Definition

The time stamp when the action was completed (including error return) from the perspective of the reporting system.

ShortTime of action response
Control0..1
Typeinstant
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
48. DTRMetricData.action.httpResponse
Definition

The HTTP response status code associated with the action (successful or not).

ShortHTTP response status code
Comments

Must be present unless action is a userresponse

Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
50. DTRMetricData.action.questionnaire
Definition

The questionnaire(s) tied to the current action

ShortAssociated Questionnaire
Control0..1
Typecanonical(DTR Standard Questionnaire, DTR Questionnaire for adaptive form)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
52. DTRMetricData.action.issue
Definition

If an OperationOutcome is returned, what were the issues?

ShortOperationOutcome info
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. DTRMetricData.action.issue.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
56. DTRMetricData.action.issue.code
Definition

The issue.code value from the OperationOutcome for this issue.

ShortError code
Control1..1
BindingThe codes SHALL be taken from IssueType
(required to http://hl7.org/fhir/ValueSet/issue-type)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
58. DTRMetricData.action.issue.details
Definition

The issue.details value from the OperationOutcome for this issue.

ShortMore detailed error code
Control0..1
BindingFor example codes, see OperationOutcomeCodes
(example to http://hl7.org/fhir/ValueSet/operation-outcome)
TypeCodeableConcept
60. DTRMetricData.resources
Definition

Information that was accessed from the EHR by the one or more of the questionnaires using CQL.

ShortResource types accessed
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. DTRMetricData.resources.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
64. DTRMetricData.resources.type
Definition

What kind of resource was accessed.

ShortKind of resource
Control1..1
BindingThe codes SHALL be taken from ResourceType
(required to http://hl7.org/fhir/ValueSet/resource-types)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
66. DTRMetricData.resources.profile
Definition

Indicates the sub-type of data accessed in situations where multiple US-core profiles could apply (e.g., Observation). Note: This does not mean that the data received was actually valid against the profile, merely that the search criteria used were intended to retrieve data of this type.

ShortSolicited profile
Control0..1
Typecanonical(StructureDefinition)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
68. DTRMetricData.resources.count
Definition

How many resources of that type were accessed.

ShortNumber retrieved
Control1..1
TypepositiveInt
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
70. DTRMetricData.questionnaire
Definition

Questionnaire that was returned in the Questionnaire package (and information about what was done with it)

ShortQuestionnaire
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. DTRMetricData.questionnaire.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
74. DTRMetricData.questionnaire.reference
Definition

This is the URL for the canonical questionnaire that was returned by the $questionnaire-package operation

ShortThis is the URL for the canonical questionnaire
Control1..1
Typecanonical(DTR Standard Questionnaire, DTR Questionnaire for adaptive form)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
76. DTRMetricData.questionnaire.adaptive
Definition

If the Questionnaire is an adaptive form, the value is True.

ShortTrue if adaptive form
Control0..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Meaning if MissingQuestionnaire was a standard (non-adaptive) Questionnaire
78. DTRMetricData.questionnaire.populated
Definition

If true, indicates that the draft QuestionnaireResponse provided in the Questionnaire package Bundle included at least some answers pre-populated with payer data.

ShortWhether a pre-populated response was provided from payer
Control0..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Meaning if MissingNo population occurred
80. DTRMetricData.questionnaire.failure
Definition

A failure reported to the payer about Questionnaire content using the $log-questionnaire-errors operation.

ShortQuestionnaire errors logged to payer
Control0..*
BindingThe codes SHALL be taken from IssueType
(required to http://hl7.org/fhir/ValueSet/issue-type)
TypeCodeableConcept
82. DTRMetricData.questionnaire.reviewPrior
Definition

If the provider reviewed the QuestionnaireResponse answers prior to marking it as complete or saving it in the EHR.

ShortTrue if user reviewed answers prior to final save
Control0..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Meaning if MissingUser did not review the QuestionnaireRepsonse in this session
84. DTRMetricData.questionnaire.enabledQuestions
Definition

The count of all questions enabled in the Questionnaire at the time it was marked 'complete'.

ShortNumber of enabled questions
Comments

This element is a count of the number of enabled question items at the time the QuestionnaireResponse was last stored as part of this DTR session

Control0..1
TypepositiveInt
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
86. DTRMetricData.questionnaire.autoPopulated
Definition

The count of all questions that were auto-populated from the patient's medical record and/or by payer information.

ShortNumber of questions autopopulated
Comments

The modification may have happened in a prior session. This element is a count of the number of enabled question items with an information-origin extension of 'auto' or 'override' at the time the QuestionnaireResponse was last stored as part of this DTR session.

Control0..1
TypepositiveInt
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Meaning if MissingNo questions had their answers auto-populated
88. DTRMetricData.questionnaire.roleInteraction
Definition

A summary of the information-origin extensions for all enabled questions in the Questionnaire as they were at the time the QuestionnaireResponse was last stored within the DTR session reflecting human intervention.

ShortRole specific interactions
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
90. DTRMetricData.questionnaire.roleInteraction.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
92. DTRMetricData.questionnaire.roleInteraction.role
Definition

The type of humanrole whose questionnaire completion is summarized here. Corresponds to the information-origin.author.role. NOTE: if a form is edited by multiple people with the same roles, the items they edit or override will be aggregated together.

ShortRole of information contributor
Control1..1
BindingUnless not suitable, these codes SHALL be taken from US Core Provider Role (NUCC)
(extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role)
TypeCodeableConcept
94. DTRMetricData.questionnaire.roleInteraction.roleAction
Definition

This will indicate the type of human intervention action being summarized (auto, override or manual).

Shortoverride | manual
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Information Human Origins Value Set
(extensible to http://hl7.org/fhir/us/davinci-dtr/ValueSet/MetricsinformationOrigins)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
96. DTRMetricData.questionnaire.roleInteraction.count
Definition

This is the sum of enabled questions for the specified with an information-origin of that source AND an author.role that matches the specified role.

ShortCount of combination of role and roleInteraction
Control1..1
TypepositiveInt
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
98. DTRMetricData.questionnaire.elapsedTime
Definition

cumulative time from DTR start to QR store, including from multiple sessions.

ShortCumulative user response time that questionnaire was active in session
Control1..1
Typetime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
100. DTRMetricData.coverageInfo
Definition

Coverage information extensions returned as part of completed adaptive Questionnaires within this DTR session.

ShortCoverage information
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. DTRMetricData.coverageInfo.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
104. DTRMetricData.coverageInfo.covered
Definition

Indicates whether the service is covered.

Shortcovered | not-covered | conditional
Control0..1
BindingThe codes SHALL be taken from CRD Coverage Information Covered Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageInfo)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
106. DTRMetricData.coverageInfo.paNeeded
Definition

Indicates whether prior authorization is necessary or not, as well as considerations about applying for prior authorization.

Shortauth-needed | no-auth | satisfied | performpa | conditional
Control0..1
BindingThe codes SHALL be taken from CRD Coverage Information Prior Authorization Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/coveragePaDetail)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
108. DTRMetricData.coverageInfo.docNeeded
Definition

Indicates whether additional information is necessary (for prior auth, claims submission, or some other purpose).

Shortclinical | admin | both | conditional
Control0..1
BindingThe codes SHALL be taken from CRD Coverage Information Additional Documentation Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/AdditionalDocumentation)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
110. DTRMetricData.coverageInfo.infoNeeded
Definition

Indicates what additional inforamtion is necessary in order to determine authorization/coverage - which might be available on a later hook invocation.

Shortperformer | location | timeframe | OTH
Control0..1
BindingThe codes SHALL be taken from CRD Information Needed Value Set
(required to http://hl7.org/fhir/us/davinci-crd/ValueSet/informationNeeded)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
112. DTRMetricData.coverageInfo.questionnaire
Definition

Information about the Questionnaire(s) returned to gather additional information (e.g. through DTR).

ShortQuestionnaire(s) returned
Control0..*
TypeBackboneElement
Requirements

Allows linking metadata about forms identified 'to be filled out' in CRD with what is actually completed in DTR, and eventually submitted in CDex, PAS or claims

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
114. DTRMetricData.coverageInfo.questionnaire.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
116. DTRMetricData.coverageInfo.questionnaire.reference
Definition

The official identifier of one of the Questionnaires provided to be filled out.

ShortQuestionnaire url & version
Control1..1
Typecanonical(Questionnaire)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
118. DTRMetricData.coverageInfo.questionnaire.adaptive
Definition

If true, indicates that the questionnaire is adaptive (i.e. uses the $next-question operation to determine questions).

ShortIs questionnaire adaptive?
Control1..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
120. DTRMetricData.coverageInfo.questionnaire.response
Definition

If true, indicates that the card included a partially populated QuestionnaireResponse with answers filled by the payer from pre-known data.

ShortPre-pop response provided?
Control1..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
122. DTRMetricData.coverageInfo.assertionId
Definition

Corresponds to the coverage-assertion-id from the coverage-information extension.

ShortId for coverage assertion
Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Requirements

Used to link the results of CRD to metric information captured for DTR and/or PAS.

124. DTRMetricData.coverageInfo.satisfiedId
Definition

Corresponds to the satisfied-pa-id from the coverage-information extension.

ShortId if PA is satisfied
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
126. DTRMetricData.coverageInfo.businessLine
Definition

A code that indicates which type of insurance this assertion applies to.

ShortE.g. MedicareAdvantage
Control0..1
TypeCodeableConcept

Guidance on how to interpret the contents of this table can be found here

0. DTRMetricData
Definition

A logical model describing the information that should be captured by DTR implementers about every DTR invocation to support measures evaluating DTR implementation.

ShortDTR Metric Data
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. DTRMetricData.source
Definition

A code to indicate which type of system collected the metric data (DTRApp can be either a Native or SMART on FHIR app)

Shortprovider-src | payer-src | DTRApp-src
Control1..1
BindingThe codes SHALL be taken from Metric Source
(required to http://hl7.org/fhir/us/davinci-dtr/ValueSet/metric-Source)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
4. DTRMetricData.sofApp
Definition

The URL of SMART on FHIR application to identify the specific DTR application used by the provider and payer. If not present, then the DTR session is with a Full EHR.

ShortURL of SMART on FHIR application
Control0..1
Typeurl
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
6. DTRMetricData.providerId
Definition

The NPI number of the user who initiated this DTR session.

ShortIdentifier for the user initiating DTR
Control1..1
TypeIdentifier
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. DTRMetricData.providerId.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
10. DTRMetricData.providerId.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on DTRMetricData.providerId.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 12. DTRMetricData.providerId.use
    Definition

    The purpose of this identifier.

    Shortusual | official | temp | secondary | old (If known)
    Comments

    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

    Control0..1
    BindingThe codes SHALL be taken from IdentifierUse
    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

    Identifies the purpose for this identifier, if known .

    Typecode
    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. DTRMetricData.providerId.type
    Definition

    A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

    ShortDescription of identifier
    Comments

    This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

    Control0..1
    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
    (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

    A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Requirements

    Allows users to make use of identifiers when the identifier system is not known.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. DTRMetricData.providerId.system
    Definition

    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

    ShortThe namespace for the identifier value
    Comments

    Identifier.system is always case sensitive.

    Control1..1
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

    Pattern Valuehttp://hl7.org/fhir/sid/us-npi
    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. DTRMetricData.providerId.value
    Definition

    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

    ShortThe value that is unique
    Comments

    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

    Control1..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Example<br/><b>General</b>:123456
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. DTRMetricData.providerId.period
    Definition

    Time period during which identifier is/was valid for use.

    ShortTime period when id is/was valid for use
    Control0..1
    TypePeriod
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. DTRMetricData.providerId.assigner
    Definition

    Organization that issued/manages the identifier.

    ShortOrganization that issued id (may be just text)
    Comments

    The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

    Control0..1
    TypeReference(Organization)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. DTRMetricData.groupId
    Definition

    The NPI of the hospital/clinic/other organization that initiated this DTR session.

    ShortIdentifier for the healthcare organization initiating DTR
    Control1..1
    TypeIdentifier
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. DTRMetricData.groupId.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    28. DTRMetricData.groupId.extension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on DTRMetricData.groupId.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 30. DTRMetricData.groupId.use
      Definition

      The purpose of this identifier.

      Shortusual | official | temp | secondary | old (If known)
      Comments

      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUse
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

      Identifies the purpose for this identifier, if known .

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. DTRMetricData.groupId.type
      Definition

      A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

      ShortDescription of identifier
      Comments

      This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
      (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

      A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Requirements

      Allows users to make use of identifiers when the identifier system is not known.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. DTRMetricData.groupId.system
      Definition

      Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

      ShortThe namespace for the identifier value
      Comments

      Identifier.system is always case sensitive.

      Control1..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

      Pattern Valuehttp://hl7.org/fhir/sid/us-npi
      Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. DTRMetricData.groupId.value
      Definition

      The portion of the identifier typically relevant to the user and which is unique within the context of the system.

      ShortThe value that is unique
      Comments

      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

      Control1..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Example<br/><b>General</b>:123456
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. DTRMetricData.groupId.period
      Definition

      Time period during which identifier is/was valid for use.

      ShortTime period when id is/was valid for use
      Control0..1
      TypePeriod
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. DTRMetricData.groupId.assigner
      Definition

      Organization that issued/manages the identifier.

      ShortOrganization that issued id (may be just text)
      Comments

      The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

      Control0..1
      TypeReference(Organization)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. DTRMetricData.payerId
      Definition

      The identifier of the payer organization supplying the questionnaire bundle for this session.

      ShortPayer receiving DTR request
      Control1..1
      TypeIdentifier
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. DTRMetricData.payerId.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      46. DTRMetricData.payerId.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on DTRMetricData.payerId.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 48. DTRMetricData.payerId.use
        Definition

        The purpose of this identifier.

        Shortusual | official | temp | secondary | old (If known)
        Comments

        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

        Control0..1
        BindingThe codes SHALL be taken from IdentifierUse
        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

        Identifies the purpose for this identifier, if known .

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. DTRMetricData.payerId.type
        Definition

        A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

        ShortDescription of identifier
        Comments

        This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

        Control0..1
        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
        (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

        A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

        Allows users to make use of identifiers when the identifier system is not known.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. DTRMetricData.payerId.system
        Definition

        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

        ShortThe namespace for the identifier value
        Comments

        Identifier.system is always case sensitive.

        Control1..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. DTRMetricData.payerId.value
        Definition

        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

        ShortThe value that is unique
        Comments

        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

        Control1..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Example<br/><b>General</b>:123456
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. DTRMetricData.payerId.period
        Definition

        Time period during which identifier is/was valid for use.

        ShortTime period when id is/was valid for use
        Control0..1
        TypePeriod
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. DTRMetricData.payerId.assigner
        Definition

        Organization that issued/manages the identifier.

        ShortOrganization that issued id (may be just text)
        Comments

        The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

        Control0..1
        TypeReference(Organization)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. DTRMetricData.assertionId
        Definition

        Assertion ids passed in on the coverage-information in Requests, Encounters, or QuestionnaireResponses used as context to launch DTR (or selected by the user as context post-launch) as well as passed as a Task questionnaire launch context parameter.

        ShortUnique ID for order item
        Comments

        If there are multiple coverage-information extensions in context, this will be the union of distinct assertionIds.

        Control0..*
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Requirements

        Allows linking DTR sessions to CRD, CDex, and potentially prior DTR sessions.

        62. DTRMetricData.docReason
        Definition

        doc-purpose passed in on the coverage-information in Requests, Encounters or QuestoinnaireResponses used as context to launch DTR (or selected by the user as context post-launch).

        Shortwithpa | withclaim | withorder | retain-doc | OTH
        Comments

        If there were multiple coverage-informations present in the launch context, this will be the union of distinct codes present.

        Control0..*
        BindingThe codes SHALL be taken from CRD Coverage Information Documentation Reason Value Set
        (required to http://hl7.org/fhir/us/davinci-crd/ValueSet/DocReason)
        Typecode
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        64. DTRMetricData.launchMode
        Definition

        Indicates the launch mode involved for this session.

        Shortcrdlaunch | relaunch | salaunch | cdexlaunch
        Control0..1
        BindingThe codes SHALL be taken from Metric Launch Mode
        (required to http://hl7.org/fhir/us/davinci-dtr/ValueSet/metric-launchmode)
        Typecode
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        66. DTRMetricData.orderItem
        Definition

        The specific procedure, item, medication, appointment, nutrition that is the subject of the order/appointment.

        ShortWhat was ordered
        Control1..*
        BindingUnless not suitable, these codes SHALL be taken from CRD Order Detail Codes Value Set
        (extensible to http://hl7.org/fhir/us/davinci-crd/ValueSet/orderDetail)
        TypeCodeableConcept
        68. DTRMetricData.action
        Definition

        Actions performed between a system and the DTR application.

        ShortActions the reporting system engaged in as part of the DTR session.
        Comments

        See notes section below for how the action elements should be populated for different actions

        Control1..*
        TypeBackboneElement
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. DTRMetricData.action.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        72. DTRMetricData.action.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on DTRMetricData.action.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 74. DTRMetricData.action.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          76. DTRMetricData.action.actionDetail
          Definition

          What type of action occurred within the DTR session.

          Shortlaunch | qpackage | mrquery | userresponse | nextq | storeqr
          Control1..1
          BindingThe codes SHALL be taken from Metric Action
          (required to http://hl7.org/fhir/us/davinci-dtr/ValueSet/metric-Action)
          Typecode
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          78. DTRMetricData.action.requestTime
          Definition

          The time stamp when the action was initiated from the perspective of the reporting system.

          ShortTime action initiated
          Control1..1
          Typeinstant
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          80. DTRMetricData.action.responseTime
          Definition

          The time stamp when the action was completed (including error return) from the perspective of the reporting system.

          ShortTime of action response
          Control0..1
          Typeinstant
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          82. DTRMetricData.action.httpResponse
          Definition

          The HTTP response status code associated with the action (successful or not).

          ShortHTTP response status code
          Comments

          Must be present unless action is a userresponse

          Control0..1
          Typeinteger
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          84. DTRMetricData.action.questionnaire
          Definition

          The questionnaire(s) tied to the current action

          ShortAssociated Questionnaire
          Control0..1
          Typecanonical(DTR Standard Questionnaire, DTR Questionnaire for adaptive form)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          86. DTRMetricData.action.issue
          Definition

          If an OperationOutcome is returned, what were the issues?

          ShortOperationOutcome info
          Control0..*
          TypeBackboneElement
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          88. DTRMetricData.action.issue.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          90. DTRMetricData.action.issue.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on DTRMetricData.action.issue.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 92. DTRMetricData.action.issue.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            94. DTRMetricData.action.issue.code
            Definition

            The issue.code value from the OperationOutcome for this issue.

            ShortError code
            Control1..1
            BindingThe codes SHALL be taken from IssueType
            (required to http://hl7.org/fhir/ValueSet/issue-type)
            Typecode
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            96. DTRMetricData.action.issue.details
            Definition

            The issue.details value from the OperationOutcome for this issue.

            ShortMore detailed error code
            Control0..1
            BindingFor example codes, see OperationOutcomeCodes
            (example to http://hl7.org/fhir/ValueSet/operation-outcome)
            TypeCodeableConcept
            98. DTRMetricData.resources
            Definition

            Information that was accessed from the EHR by the one or more of the questionnaires using CQL.

            ShortResource types accessed
            Control0..*
            TypeBackboneElement
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            100. DTRMetricData.resources.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            102. DTRMetricData.resources.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on DTRMetricData.resources.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 104. DTRMetricData.resources.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              106. DTRMetricData.resources.type
              Definition

              What kind of resource was accessed.

              ShortKind of resource
              Control1..1
              BindingThe codes SHALL be taken from ResourceType
              (required to http://hl7.org/fhir/ValueSet/resource-types)
              Typecode
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              108. DTRMetricData.resources.profile
              Definition

              Indicates the sub-type of data accessed in situations where multiple US-core profiles could apply (e.g., Observation). Note: This does not mean that the data received was actually valid against the profile, merely that the search criteria used were intended to retrieve data of this type.

              ShortSolicited profile
              Control0..1
              Typecanonical(StructureDefinition)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              110. DTRMetricData.resources.count
              Definition

              How many resources of that type were accessed.

              ShortNumber retrieved
              Control1..1
              TypepositiveInt
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              112. DTRMetricData.questionnaire
              Definition

              Questionnaire that was returned in the Questionnaire package (and information about what was done with it)

              ShortQuestionnaire
              Control0..*
              TypeBackboneElement
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              114. DTRMetricData.questionnaire.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              116. DTRMetricData.questionnaire.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on DTRMetricData.questionnaire.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 118. DTRMetricData.questionnaire.modifierExtension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                Summarytrue
                Requirements

                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                Alternate Namesextensions, user content, modifiers
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                120. DTRMetricData.questionnaire.reference
                Definition

                This is the URL for the canonical questionnaire that was returned by the $questionnaire-package operation

                ShortThis is the URL for the canonical questionnaire
                Control1..1
                Typecanonical(DTR Standard Questionnaire, DTR Questionnaire for adaptive form)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                122. DTRMetricData.questionnaire.adaptive
                Definition

                If the Questionnaire is an adaptive form, the value is True.

                ShortTrue if adaptive form
                Control0..1
                Typeboolean
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Meaning if MissingQuestionnaire was a standard (non-adaptive) Questionnaire
                124. DTRMetricData.questionnaire.populated
                Definition

                If true, indicates that the draft QuestionnaireResponse provided in the Questionnaire package Bundle included at least some answers pre-populated with payer data.

                ShortWhether a pre-populated response was provided from payer
                Control0..1
                Typeboolean
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Meaning if MissingNo population occurred
                126. DTRMetricData.questionnaire.failure
                Definition

                A failure reported to the payer about Questionnaire content using the $log-questionnaire-errors operation.

                ShortQuestionnaire errors logged to payer
                Control0..*
                BindingThe codes SHALL be taken from IssueType
                (required to http://hl7.org/fhir/ValueSet/issue-type)
                TypeCodeableConcept
                128. DTRMetricData.questionnaire.reviewPrior
                Definition

                If the provider reviewed the QuestionnaireResponse answers prior to marking it as complete or saving it in the EHR.

                ShortTrue if user reviewed answers prior to final save
                Control0..1
                Typeboolean
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Meaning if MissingUser did not review the QuestionnaireRepsonse in this session
                130. DTRMetricData.questionnaire.enabledQuestions
                Definition

                The count of all questions enabled in the Questionnaire at the time it was marked 'complete'.

                ShortNumber of enabled questions
                Comments

                This element is a count of the number of enabled question items at the time the QuestionnaireResponse was last stored as part of this DTR session

                Control0..1
                TypepositiveInt
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                132. DTRMetricData.questionnaire.autoPopulated
                Definition

                The count of all questions that were auto-populated from the patient's medical record and/or by payer information.

                ShortNumber of questions autopopulated
                Comments

                The modification may have happened in a prior session. This element is a count of the number of enabled question items with an information-origin extension of 'auto' or 'override' at the time the QuestionnaireResponse was last stored as part of this DTR session.

                Control0..1
                TypepositiveInt
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Meaning if MissingNo questions had their answers auto-populated
                134. DTRMetricData.questionnaire.roleInteraction
                Definition

                A summary of the information-origin extensions for all enabled questions in the Questionnaire as they were at the time the QuestionnaireResponse was last stored within the DTR session reflecting human intervention.

                ShortRole specific interactions
                Control0..*
                TypeBackboneElement
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                136. DTRMetricData.questionnaire.roleInteraction.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                138. DTRMetricData.questionnaire.roleInteraction.extension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortAdditional content defined by implementations
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on DTRMetricData.questionnaire.roleInteraction.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 140. DTRMetricData.questionnaire.roleInteraction.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  142. DTRMetricData.questionnaire.roleInteraction.role
                  Definition

                  The type of humanrole whose questionnaire completion is summarized here. Corresponds to the information-origin.author.role. NOTE: if a form is edited by multiple people with the same roles, the items they edit or override will be aggregated together.

                  ShortRole of information contributor
                  Control1..1
                  BindingUnless not suitable, these codes SHALL be taken from US Core Provider Role (NUCC)
                  (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role)
                  TypeCodeableConcept
                  144. DTRMetricData.questionnaire.roleInteraction.roleAction
                  Definition

                  This will indicate the type of human intervention action being summarized (auto, override or manual).

                  Shortoverride | manual
                  Control1..1
                  BindingUnless not suitable, these codes SHALL be taken from Information Human Origins Value Set
                  (extensible to http://hl7.org/fhir/us/davinci-dtr/ValueSet/MetricsinformationOrigins)
                  Typecode
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  146. DTRMetricData.questionnaire.roleInteraction.count
                  Definition

                  This is the sum of enabled questions for the specified with an information-origin of that source AND an author.role that matches the specified role.

                  ShortCount of combination of role and roleInteraction
                  Control1..1
                  TypepositiveInt
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  148. DTRMetricData.questionnaire.elapsedTime
                  Definition

                  cumulative time from DTR start to QR store, including from multiple sessions.

                  ShortCumulative user response time that questionnaire was active in session
                  Control1..1
                  Typetime
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  150. DTRMetricData.coverageInfo
                  Definition

                  Coverage information extensions returned as part of completed adaptive Questionnaires within this DTR session.

                  ShortCoverage information
                  Control0..*
                  TypeBackboneElement
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  152. DTRMetricData.coverageInfo.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  154. DTRMetricData.coverageInfo.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on DTRMetricData.coverageInfo.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 156. DTRMetricData.coverageInfo.modifierExtension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                    Summarytrue
                    Requirements

                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                    Alternate Namesextensions, user content, modifiers
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    158. DTRMetricData.coverageInfo.covered
                    Definition

                    Indicates whether the service is covered.

                    Shortcovered | not-covered | conditional
                    Control0..1
                    BindingThe codes SHALL be taken from CRD Coverage Information Covered Value Set
                    (required to http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageInfo)
                    Typecode
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    160. DTRMetricData.coverageInfo.paNeeded
                    Definition

                    Indicates whether prior authorization is necessary or not, as well as considerations about applying for prior authorization.

                    Shortauth-needed | no-auth | satisfied | performpa | conditional
                    Control0..1
                    BindingThe codes SHALL be taken from CRD Coverage Information Prior Authorization Value Set
                    (required to http://hl7.org/fhir/us/davinci-crd/ValueSet/coveragePaDetail)
                    Typecode
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    162. DTRMetricData.coverageInfo.docNeeded
                    Definition

                    Indicates whether additional information is necessary (for prior auth, claims submission, or some other purpose).

                    Shortclinical | admin | both | conditional
                    Control0..1
                    BindingThe codes SHALL be taken from CRD Coverage Information Additional Documentation Value Set
                    (required to http://hl7.org/fhir/us/davinci-crd/ValueSet/AdditionalDocumentation)
                    Typecode
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    164. DTRMetricData.coverageInfo.infoNeeded
                    Definition

                    Indicates what additional inforamtion is necessary in order to determine authorization/coverage - which might be available on a later hook invocation.

                    Shortperformer | location | timeframe | OTH
                    Control0..1
                    BindingThe codes SHALL be taken from CRD Information Needed Value Set
                    (required to http://hl7.org/fhir/us/davinci-crd/ValueSet/informationNeeded)
                    Typecode
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    166. DTRMetricData.coverageInfo.questionnaire
                    Definition

                    Information about the Questionnaire(s) returned to gather additional information (e.g. through DTR).

                    ShortQuestionnaire(s) returned
                    Control0..*
                    TypeBackboneElement
                    Requirements

                    Allows linking metadata about forms identified 'to be filled out' in CRD with what is actually completed in DTR, and eventually submitted in CDex, PAS or claims

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    168. DTRMetricData.coverageInfo.questionnaire.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    170. DTRMetricData.coverageInfo.questionnaire.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on DTRMetricData.coverageInfo.questionnaire.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 172. DTRMetricData.coverageInfo.questionnaire.modifierExtension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                      ShortExtensions that cannot be ignored even if unrecognized
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      TypeExtension
                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                      Summarytrue
                      Requirements

                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                      Alternate Namesextensions, user content, modifiers
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      174. DTRMetricData.coverageInfo.questionnaire.reference
                      Definition

                      The official identifier of one of the Questionnaires provided to be filled out.

                      ShortQuestionnaire url & version
                      Control1..1
                      Typecanonical(Questionnaire)
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      176. DTRMetricData.coverageInfo.questionnaire.adaptive
                      Definition

                      If true, indicates that the questionnaire is adaptive (i.e. uses the $next-question operation to determine questions).

                      ShortIs questionnaire adaptive?
                      Control1..1
                      Typeboolean
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      178. DTRMetricData.coverageInfo.questionnaire.response
                      Definition

                      If true, indicates that the card included a partially populated QuestionnaireResponse with answers filled by the payer from pre-known data.

                      ShortPre-pop response provided?
                      Control1..1
                      Typeboolean
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      180. DTRMetricData.coverageInfo.assertionId
                      Definition

                      Corresponds to the coverage-assertion-id from the coverage-information extension.

                      ShortId for coverage assertion
                      Control1..1
                      Typestring
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Requirements

                      Used to link the results of CRD to metric information captured for DTR and/or PAS.

                      182. DTRMetricData.coverageInfo.satisfiedId
                      Definition

                      Corresponds to the satisfied-pa-id from the coverage-information extension.

                      ShortId if PA is satisfied
                      Control0..1
                      Typestring
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      184. DTRMetricData.coverageInfo.businessLine
                      Definition

                      A code that indicates which type of insurance this assertion applies to.

                      ShortE.g. MedicareAdvantage
                      Control0..1
                      TypeCodeableConcept