QI-Core Implementation Guide
5.0.0-ballot - STU Ballot US

This page is part of the Quality Improvement Core Framework (v5.0.0-ballot: STU 5 Ballot 1) based on FHIR R4. The current version which supercedes this version is 4.1.1. For a full list of available versions, see the Directory of published versions

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide

QICore AdverseEvent

An adverse event is an untoward occurrence during treatment that should be reported, for example, to a clinical study sponsor or safety oversight organization. AEs include reportable serious medical errors such as those defined by National Quality Forum (see http://www.qualityforum.org/Topics/ SREs/List_of_SREs.aspx), and Patient Safety Healthcare Events as defined by AHRQ. Some AEs can involve conditions such as “recurring headaches” but others do not, such as accidental falls, surgical errors, sexual abuse of patient, and sudden death. An adverse event can also be an unsafe condition that increases the probability of a patient safety event, and near-misses. An adverse event can be caused by exposure to some agent (e.g., a medication, immunization, food, or environmental agent). An adverse reaction can range from a mild reaction, such as a harmless rash to a severe and life-threatening condition. They can occur immediately or develop over time. For example, a patient may develop a rash after taking a particular medication.

QICore Allergy Intolerance

Profile of AllergyIntolerance for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICore Care Plan

Defines constraints and extensions on the CarePlan resource for the minimal set of data to query and retrieve a patient’s Care Plan.

QICore CareTeam

Profile of CareTeam for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICore Claim Response

The QI Core ClaimResponse profile is used to provide the results of the adjudication and/or authorization of a set of healthcare-related products and services for a patient against the patient’s insurance coverages, or to respond with what the adjudication would be for a supplied set of products or services should they be actually supplied to the patient.It identifies the mandatory core elements, extensions, vocabularies and value sets which SHALL be present in the ClaimResponse resource when using this profile

QICore Condition Encounter Diagnosis

The QI Core Condition Encounter Diagnosis Profile is based upon the US Core Condition Encounter Diagnosis Profile. In version 5.0.0, The QI Core Condition Profile has been split into the QI Core Condition Encounter Diagnosis Profile and QI Core Condition Problems and Health Concerns Profile. To promote interoperability and adoption through common implementation, this profile defines constraints and extensions on the Condition resource for the minimal set of data to record, search, and fetch information about an encounter diagnosis. It Defines the core set of elements and extensions for quality rule and measure authors.

QICore Condition Problems Health Concerns

Profile of Condition for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICore Coverage

Profile of Coverage for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICore DiagnosticReport Profile for Laboratory Results Reporting

Profile of DiagnosticReport for laboratory results for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICore DiagnosticReport Profile for Report and Note Exchange

Profile of DiagnosticReport for Note exchange for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICore Encounter

Profile of Encounter for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICore Goal

Profile of Goal for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICore Imaging Study

Profile of ImagingStudy for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICore Immunization

Profile of Immunization for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICore Immunization Not Done

Negation profile of Immunization for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICore Laboratory Result Observation

The QI Core Laboratory Result Observation Profile is based upon the US Laboratory Result Observation Resource. Defines the core set of elements and extensions for quality rule and measure authors.

QICore Medication

Profile of Medication for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICore MedicationRequest

Profile of MedicationRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICore Medication Not Requested

Negation profile of MedicationRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICore Observation Clinical Test Result

The QI Core Observation Clinical Test Result Profile is based upon the US Core Observation Clinical Test Result Profile. Clinical tests includes non-imaging and non-laboratory tests performed on a patient that results in structured or unstructured (narrative) findings specific to the patient, such as electrocardiogram (ECG), visual acuity exam, macular exam, or graded exercise testing (GXT), to facilitate the diagnosis and management of conditions. The QI Core Observation Clinical Test Result Profile profile defines the core set of elements and extensions for quality rule and measure authors.

QICore Observation Imaging Result

The QI Core Observation Imaging Result Profile is based upon the US Core Observation Imaging Profile. To promote interoperability and adoption through common implementation, this profile sets minimum expectations for components of diagnostic imaging test results for a patient and defines the core set of elements and extensions for quality rule and measure authors.

QICore Observation Survey

The QI Core Observation Survey Profile is based upon the US Core Observation Survey Profile which can be used to represent individual responses, panels of multi-question surveys, and multi-select responses to “check all that apply” questions. The QI Core Observation Survey Profile sets minimum expectations for the Observation Resource to record, search, and fetch retrieve observations that represent the questions and responses to form/survey and and defines the core set of elements and extensions for quality rule and measure authors.

QICore Observation

Profile of Observation for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICore Practitioner

Profile of Practitioner for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICore QuestionnaireResponse

The QI Core QuestionnaireResponse Profile is based upon the US Core QuestionnaireResponse Profile and sets minimum expectations for the QuestionnaireResponse resource to record, search, and fetch retrieve captures the responses to form/survey and defines the core set of elements and extensions for quality rule and measure authors.

QICore Service Not Requested

Negation profile of ServiceRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICore Service Request

Profile of ServiceRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreBodyStructure

Profile of BodyStructure for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreClaim

Profile of Claim for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreCommunication

Profile of Communication for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreCommunicationNotDone

Profile of CommunicationNotDone for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreCommunicationRequest

Profile of CommunicationRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreDevice

Profile of Device for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreDeviceNotRequested

Profile of DeviceRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreDeviceRequest

Profile of DeviceRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreDeviceUseStatement

Profile of DeviceUseStatement for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreFamilyMemberHistory

Profile of Family Member History for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreFlag

Profile of Flag for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreImmunizationEvaluation

Defines constraints and extensions on the ImmunizationEvaluation resource for the minimal set of data to query and retrieve a patient’s Immunization Evaluation.

QICoreImmunizationRecommendation

Profile of ImmunizationRecommendation for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreLocation

Profile of Location for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreMedicationAdministration

Profile of MedicationAdministration for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreMedicationDispense

Profile of MedicationDispense for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreMedicationDispenseNotDone

Negation profile of MedicationDispense for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreMedicationStatement

Profile of MedicationStatement for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreMedicationAdministrationNotDone

Negation profile of MedicationAdministration for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreNutritionOrder

Defines constraints and extensions on the NutritionOrder resource for the minimal set of data to query and retrieve a patient’s Nutrition Order.

QICoreObservationNotDone

Profile of ObservationNotDone for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreOrganization

Profile of Organization for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICorePatient

Profile of Patient for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICorePractitionerRole

Profile of PractitionerRole for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreProcedure

Profile of Procedure for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreProcedureNotDone

Profile of Procedure for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreRelatedPerson

Profile of RelatedPerson for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreSpecimen

Profile of Specimen for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreSubstance

Profile of Substance for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreTask

Profile of Task for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QICoreTaskNotDone

Profile of TaskNotDone for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide

DoNotPerformReason

DoNotPerformReason Extension

QICoreDiagnosisPresentOnAdmission

Indicator of whether the Encounter diagnosis was present at the time of admission.

Encounter Procedure Extension

Procedures performed during the encounter, or as the primary reason for the encounter.

QICore IsElective

Indicates whether this is an elective procedure.

Not Done Value Set

A logical reference (e.g. a reference to ValueSet.url) to a value set/version that identifies a set of possible coded values representing activities that were not requested, ordered, or performed.

RAND Appropriateness Score Extension

The RAND appropriateness score for the requested procedure.

QICoreNotDoneReason

Indicates the reason the event was not done.

QICoreNotDoneRecorded

Captures the recorded date of the event.

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide

Reasons for refuting allergy or intolerance codes

The value set to instantiate this attribute should be drawn from a terminologically robust code system for reasons of refuting an allergy or intolerance. This value set is provided as a suggestive example.

RAND Appropriateness Scores

The RAND scoring for appropriateness of the procedure.

Precoordinated Body Structures

SELECT SNOMED CT code system values representing precoordinated body structures.

Communication reason not performed codes

Reason communication was not performed. A set of codes specifying the motivation, cause, or rationale of not performing a communication such as being rejected or refused. This value set is provided as a suggestive example.

Condition/Diagnosis Certainty

Example value set for Condition/Problem/Diagnosis certainty

QICore Condition Criticality

Value Set for QICore Condition Criticality (Example)

Disease Stage Value Set

A period or phase in the course of a disease, or the degree of involvement or severity of a disease. Stage acts as a qualifier for the condition.

Reasons for canceled or refused encounter codes

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support the encounter process, in particular the process and reasons for canceling or refusing an encounter. This value set is provided as a suggestive example

SNOMED CT Qualifier For Type of Diagnosis Codes

This value set includes all the “Qualifier for type of diagnosis” SNOMED CT codes (i.e. codes with an is-a relationship with 106229004: Qualifier for type of diagnosis).

QICore Encounter Clinical Discharge Disposition Codes

This value set defines a set of codes that can be used to where the patient left the hospital.

Flag Category Codes

Value Set for Flag Category (Example). This value set defines category codes for Patient Record Flags. Patient record flags is a mechanism in which an alert can be assigned to patients who have certain high risk clinical needs or behavior problems. Flags can be configured to appear during the patient look-up process.

Reasons for rejecting goal codes

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support the goal process, in particular the process and reasons for rejecting a goal. This value set is provided as a suggestive example.

SNOMED CT Dosages Codes

This value set includes all the “Dosages” SNOMED CT codes (i.e. codes with an is-a relationship with 277406006: Dosages).

Negation Reason Codes

This value set defines the set of codes that can be used to indicate the reason an action was not taken

Body Position

SNOMED CT code system values descending from the following:’body position finding’ 9851009

QICore Observation Delta Value Set Definition

Code indicating how the current observation compares to previous observations - e.g., no change, rising trend, decreasing trend, etc…

QICore Observation Verification Method

Code for method by which the observation result was validated, e.g., human review, sliding average.

Disability Value Set

Disability is broadly defined as a physical or mental condition that limits a person’s movements, senses, or activities. This includes items such as handicap, impairment, invalidism, functional dependency, and incompetence.

SNOMED CT Priorities Codes

This value set includes all the “Priorities” SNOMED CT codes (i.e. codes with an is-a relationship with 272125009: Priorities).

QICoreProcedureType

This value set includes example Procedure Type codes

QICore Present On Admission Codes

Value Set for QICore Present On Admission.

Reasons for rejecting a service request

The value set to instantiate this attribute should be drawn from a terminologically robust code system for reasons of rejecting or canceling a referral request. This value set is provided as a suggestive example.

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide

RAND Appropriateness Score Codes

The RAND scoring for appropriateness of the procedure.

QICore Communication Medium Codes

Value Set for QICore Communication Medium (Example)

QICore Condition Criticality Codes

Value Set for QICore Condition Criticality (Example)

QICore Diagnostic Order Precondition

The condition, state, or problem that the patient is in or has prior to a therapy or procedure. This captures temporal (temporary circumstances) that have bearing on the data that it qualifies but will not necessarily modify its meaning. Things like ‘after activity’, ‘at rest’, or ‘post-op’.

QICore Observation Verification Method Codes

Code for method by which the observation result was validated, e.g., human review, sliding average.

Knowledge Artifacts: Libraries

These define logic, asset collections and other libraries as part of content in this implementation guide

QICore Model Definition

Model definition for the QI-Core IG (v4.1.0) Model

QICore Common

This library defines functions to expose extensions defined in QICore as fluent functions in CQL, as well as common terminology and functions used in writing CQL with FHIR and QICore profiles.

QICore Common Tests

This library defines tests for the QICoreCommon library.

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like

AdverseEvent example

Example of an allergic reaction adverse event

AllergyIntrolerance example

Example of a clinical assesment record of an allergy

AllergyIntrolerance refuted example

Example of a clinical assesment record of an allergy that has been refuted

BodyStructure example

Example of a BodyStructure resource to identify a mass in the spleen

CarePlan example

Example of an assessment and care plan for a pregnancy

CareTeam example

Example of a CareTeam involved in the delivery of care for a pregnancy

Claim example

Example of a vision claim

ClaimResponse example

Example of a vision claim response

Communication example

Example of a notification sent to a patient about an abnormal test result

Communication negation example

Example of a notification that failed to be sent to a patient and reason why

CommunicationRequest example

Example of a record of request to provide additional information for a claim

Condition Encounter Diagnosis example

Example of a condition encounter diagnosis resource used to record information about a burn of the left ear

Condition Problems Health Concerns example

Example of a patient with a condition encounter health concern regarding obesity

Condition example - appendicitis

Example of a condition resource used to record information about an appendicitis

Coverage example

Example of a coverage resource used to provide information about an individuals specific plan

Coverage example - Subscriber ID

Example of a coverage resource used to provide information about an individuals specific plan with a Subscriber Id

Device example

Device example for an ECG

DeviceRequest example

Request to employ a medical device

DeviceRequest negation example

Example of a request to employ a medical device that was not performed

DeviceRequest negation with code example

Example of a request to employ a medical device that was not performed

DeviceUseStatement example

Example of a record of device use by a patient

DiagnosticReportLab example

Example of a the findings and interpretation of a laboratory diagnostic test

DiagnosticReportNote example

Example of a DiagnosticReport Note

Encounter example

Example of an Encounter

FamilyMemberHistory example

Example of Family Member History for a patient

Flag example

Warning/Notification when providing care example

Goal example

Example of weight loss goal/objective for a patient

ImagingStudy example

Example of ImagingStudy based on CT imaging study

Immunization example

Immunization example

Immunization negation example

Example of immunization that was refused/failed to be administered using valuset

Immunization negation with code example

Example of immunization that was refused/failed to be administered using code

ImmunizationEvaluaion example

Example of ImmunizationEvaluation

ImmunizationRecommendation example

Example of ImmunizationRecommendation for Hepatitis A vaccine

Location example

Example of Location of a provider - south wing of Mean Joe Greene University Medical Center

Medication example

Example of Alemtuzumab Medication

MedicationAdministration example

Inhalent example of MedicationAdministration

MedicationAdministration Cumulative Duration example

Cumulative Medication example of MedicationAdministration

MedicationAdministration negation example

Example of medication not administered using a value set to indicate what was not administered

MedicationAdministration negation with code example

Example of medication not administered using a code to indicate that a particular medication was not administered

MedicationDispense example

Penicillin MedicationDispense Example

MedicationDispense cumulative dose example

Cumulative Medication Dispense Example

MedicationDispense negation example

Example of medication not dispensed using a valuetset to indicate the reason

MedicationDispense negation with code example

Example of medication not dispensed using a code to indicate the reason

MedicationRequest Cumulative Duration

Cumulative Medication Duration Example

MedicationRequest example

Penicillin MedicationRequest Example

MedicationRequest Patient Reported Example

Patient Reported Example

MedicationRequest Patient Requester Example

Patient Requester Example

MedicationRequest Practitioner Ordered Example

Practitioner Ordered Example

MedicationNotRequested using valueset example

Example of medication not requested using a valuetset to indicate the reason

MedicationNotRequested using code example

Example of medication not requested using a code to indicate the reason

MedicationStatment example

Penicillin MedicationStatement Example

NutrientOrder example

Example of NutrientOrder for diabetic diet

Observation example

Example of Decreased Hemoglobin Observation

ODH Observation example

Example of occupational data added to observation measure

Frailty observation example

Example of a frailty observation measure

Gestation age at birth observation example

Example of a gestation age at birth observation

ObservationNotDone with valueset example

Example of observation not done using a valueset to indicate the reason

ObservationNotDone with code example

Example of observation not done using a code to indicate the reason

Heart rate rhythm clinical test observation example

Example of a Heart rate rhythm clinical test observation

Clinical Imaging Xray Chest Findings Example

Example of a x-ray chest findings clinical imaging

10 minute Apgar Heart Rate Observation Survey Example

Example of a 10 minute Apgar Heart Rate Observation Survey

Glucose Laboratory Result Observation Example

Example of a glucose laboratory result observation

Organization example

HL7 Organization example

Patient example

Basic Patient example

65+ Female patient example

65+ Female patient example

Infant patient example

Infant patient example

Practitioner example

Referring Practitioner example

PractitionerRole example

PractitionerRole example

Procedure example

Appendectomy Procedure example

ProcedureNotDone with valueset example

Example of procedure not done using a valueset to indicate the reason

ProcedureNotDone with code example

Example of procedure not done using a code to indicate the reason

PHQ-9 QuestionnaireResponse Example

Example of a PHQ-9 Questionnaire Response

ServiceRequest example

Request for Appendectomy ServiceRequest example

ServiceRequest appropiateness example

ServiceRequest appropiateness example

ServiceNotRequested with valueset example

Example of service not requested using a valueset to indicate the reason

ServiceNotRequested with code example

Example of service not requested using a code to indicate the reason

ServiceRequest Myringotomy Procedure example

ServiceRequest for Myringotomy Procedure example

ServiceRequest elective example

Elective procedure ServiceRequest example

RelatedPerson example

Emergency contact example

Specimen example

Blood sample example

Substance example

Honey Bee venom (apitoxin) Substance example

Task example

Task example

TaskNotDone with valueset example

Example of task not done using a valueset to indicate the reason

TaskNotDone with code example

Example of task not done using a code to indicate the reason