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


This page lists the change history for each version of QI Core.

STU4.1 Release with 1 Technical Errata for FHIR R4 (v4.1.1)

  • FHIR-35873: Corrected version-independent links to USCore throughout
  • FHIR-35802: Corrected negation examples and added guidance for usage of valueset-based negation

STU4.1 Release for FHIR R4

STU4.1 (v4.1.0)

    1. Applied:Broken Link for QUICK AdverseEvent actuality value set binding (FHIR-23934)
      1. Applied:Immunization.occurrence should remove the String choice (FHIR-26407)
      2. Applied:MedicationNotDispensed (FHIR-26409)
      3. Applied:Naming of QUICK vs QI-Core Logical View (FHIR-26592)
      4. Applied:Medication list patient reported medications use Intent = Plan (not order) (FHIR-26829)
      5. Applied:wrong link in QDM to QICore mapping (FHIR-27031)
      6. Applied:Remove imagingStudy must support from the QICoreDiagnosticReportLab profile (FHIR-27163)
      7. Applied:Add TIN to QICore Organization Profile (FHIR-27804)
      8. Applied:DEQM Practitioner and DEQM Organization Profile should be added to QI Core (FHIR-28157)
      9. Applied:Patient resource generalpractitioner needs to consider PractitionerRole (https://jira.hl7.org/browse/FHIR-28220))
      10. Applied:Can you add my affiliation? (FHIR-28231)
      11. Applied:change D.role to D.use in example with Encounter.diagnosis (FHIR-28241)
      12. Applied:Add MUST HAVE for MedicationRequest timing elements (FHIR-28286)
      13. Applied:Update Present On Admission in QDM to QI Core Mapping (FHIR-29703)
      14. Applied:Change mapping of "Encounter, Performed" code from Encounter.class to Encounter.type (FHIR-29819)
      15. Applied:QDM to QI-Core mapping for AdverseEvent error (FHIR-30098)
      16. Applied:Add QICoreModelInfo (FHIR-30771)
      17. Applied:Include US Core errata (3.1.1) to QI-Core Update process (FHIR-31350)
      18. Applied:Add MedicationDispense.whenPrepared MUST SUPPORT (FHIR-31609)
      19. Applied:Update QDM to QI-Core Mapping to address QDM 5.6 (FHIR-31629)
      20. Applied:Add guidance about use of references in profiles QI-Core inherits from US Core and FHIR (FHIR-31738)
      21. Applied:Update QDM to QI-Core mapping for (FHIR-31740)
      22. Applied:Profile Procedure NOT Done - why is element code not required (FHIR-31929)
      23. Applied:Procedure NOT Done - what is the intent of the valueset-reference in Code element (FHIR-31930)
      24. Applied:Procedure NOT Done - recorded does not have a clear description (FHIR-31931)
      25. Applied:Coverage.period shows in Differential but we cannot identify the change from FHIR Core (FHIR-31932)
      26. Applied:QI Core Observation.code binding is just example to LOINC (FHIR-31933)
      27. Applied:QI Core IG does not have a Table of Contents page (FHIR-31935)
      28. Applied:QDM to QI-Core mapping Section 8.1 correct text to QDM 5.6 (FHIR-31974)
      29. Applied:Adverse Event QDM-to-QI-Core mapping errata (FHIR-31975)
      30. Applied:QDM to Qi-Core mapping AllergyIntolerance (FHIR-31976)
      31. Applied:QDM to Qi-Core sections 8.4.1, 8.4.3 Assessment Order/Recommended (FHIR-31977)
      32. Applied:QDM to QI-Core mapping Communication, Performed (FHIR-31978)
      33. Applied:QDM to Qi-Core mapping for Device Order, Device Recommended (FHIR-31979)
      34. Applied:QDM to QI-Core mapping Diagnostic Study corrections (FHIR-31980)
      35. Applied:QDM to QI-Core mapping - Encounter (FHIR-31981)
      36. Applied:QDM to QI-Core mapping Immunization Administered status error (FHIR-31982)
      37. Applied:QDM to QI-Core mapping Intervention performed errors (FHIR-31983)
      38. Applied:QDM to QI-Core mapping Laboratory order and recommended error (FHIR-31984)
      39. Applied:QDM to QI-Core mapping Medication Administered error (FHIR-31985)
      40. Applied:QDM to QI-Core mapping Medication, Discharge error (FHIR-31987)
      41. Applied:QDM to QI-Core mapping update for Medication, Dispensed (FHIR-31988)
      42. Applied:QDM to QI-Core mapping Physical Exam Order and Recommended error (FHIR-31989)
      43. Applied:QDM to QI Core mapping changes for Procedure, Order, Procedure, Recommended and Procedure, Performed (FHIR-31990)
      44. Applied:QDM to QI-Core mapping - error in Immunization, Administered not done mapping ([FHIR-32005](https://jira.hl7.org/browse/FHIR-32005
      45. Applied:QDM to QI-Core mapping for "Medication, Order" status constraints ([FHIR-32037](https://jira.hl7.org/browse/FHIR-32037
      46. Applied:CommunicationNotDone code requires change in cardinality and modeling (FHIR-32052)
      47. Applied:DeviceRequestNotDone code binding and cardinality may require a specific slice for the eCQM use case (FHIR-32053)
      48. Applied:ImmunizationNotDone should allow indication an individual immunization was not performed and a slice to indicate none of the members of a value set was performed (FHIR-32054)
      49. Applied:MedicationNotAdministered requires ability to specify a single medication or an entire value set slice (FHIR-32055)
      50. Applied:MedicationNotDispensed should allow indication of a single medication not dispensed or a slice to indicate an entire value set was not dispensed (FHIR-32056)
      51. Applied:MedicationNotRequested should allow reference to a single medication not requested or a slice for a value set of all medications not requested (FHIR-32057)
      52. Applied:ObservationNotDone should allow reference to a single observation not performed or a slice for a value set for which none of the items were performed (FHIR-32058)
      53. Applied:ServiceNotRequested requires ability to specify a single service not requested or a slice for any one of a value set of services not requested (FHIR-32059)
      54. Applied:DiagnosticReportLab does not have Performer or Issued as Must Support even though the US Core Specification Does (FHIR-32235)
      55. Applied:How to reference TaskNotDone (FHIR-32273)
      56. Applied:Create QICorePresentOnAdmission value set (FHIR-32378)
      57. Applied:Add Must Support to Procedure.usedCode (FHIR-32991)
      58. Applied:Add Must Support for ServiceRequest.intent, MedicationRequest.intent, NutritionOrder.intent, NutritionOrder.status (FHIR-33027)
      59. Applied:Update identifiers throughout (FHIR-33085)
      60. Applied:Remove Authoring section (FHIR-33260)
  1. The following tickets listed below were incorporated from the US Core errata (3.1.1):

    • Add guidance for representing patient name suffix and previous patient name to the US Core Patient Profile (FHIR-28129)
    • Correct copy/paste error in Goal Profile (FHIR-28109)
    • Correct US Core Provider Speciality (NUCC) ValueSet to hide abstract grouping codes (FHIR-27975)
    • Added example of US Core Direct Extension to Practitioner-2 Example (FHIR-27947)
    • Corrected technical errors in pediatric profiles StructureDefinitions (FHIR-27946)
    • Corrected errors in DiagnosticReport Cardiology Example (FHIR-27913)
    • Update Federal Register link for OMB race and ethnicity category classifications. (FHIR-27907)
    • Clarified token search syntax (FHIR-27897)
    • Corrected US Core DocumentReference Profile to support multiple attachments (FHIR-25778)
    • Fix FHIRPath Expression in USCoreGoalTargetDate (FHIR-27892)
    • Fix FHIRPath Expression in USCoreProcedureDate (FHIR-27887)
    • Add omitted ge comparators to SearchParameters (FHIR-27893)
    • Remove Must Support References to non US Core Profiles (FHIR-27876)
    • Add missing reaction to the US Core AllergyIntolerance Profile (FHIR-27867)
    • Clarify reference to US Core Patient in Vitals Signs Profiles (FHIR-27857)
    • Corrected US Core Pulse Oximetry Profile component.valueQuantity.code and component.valueQuantity.unit min from 0 to 1 to be consistent with the valueQuantity constraints within US Core (FHIR-27846)
    • Correct UCUM Unit in US Core Pulse Oximetry Profile Text Summary (FHIR-27845)
    • Update Procedure Codes Value Set to include ICD-10 PCS codes (FHIR-27836)
    • Update Procedure Codes Value Set to include CDT codes (FHIR-27737)
    • Clarify that pediatric vital sign percentile Observations should reference growth chart (FHIR-27549)
    • Added Missing US core Head Occipital-frontal Circumference Percentile Profile (FHIR-27542)
    • Correct requirements for supporting CLIA identifiers (FHIR-27158)
    • Change Description of ICD-10-PCS Value Set (FHIR-27116)
    • Correct AllergyIntolerance guidance for verificationStatus (FHIR-27096)
    • Fix example US Core heart-rate example (FHIR-27086)
    • Review period comments Update smoking status codes to align with USCDI (FHIR-27082)
    • Fix invariant provenance-1 (FHIR-27065)
    • Fix invalid json snippet (FHIR-27001)
    • Review period comments Remove Provenance requirement from Medication, Location, Practitioner, PractitionerRole, and Organization and correct copy and paste error to Medication and Provenance searchType support in CapabilityStatement (FHIR-26840),(FHIR-28161)
    • Correction on USCDI Table change MedicationStatement to MedicationRequest and remove references to MedicationStatement in the Medication Profile and CapabilityStatements (FHIR-26840)
    • Clarify that US Core Location/PractitionerRole are not being referenced by other resources (FHIR-26840)
    • Correct editing error restoring Write and Operation capability guidance into DocumentReference QuickStart (FHIR-26840)
    • Clarify guidance that servers SHALL support search with status if status required (FHIR-26840)
    • Correct canonical url for ImplementationGuide (FHIR-26686)
    • Correct system URI for ICD-10 procedure codes (FHIR-26679)
    • Fix invariant us-core-1 (FHIR-26605)
    • Change valueCode min from 0 to 1 for US Core Birth Sex Extension and valueBoolean min from 0 to 1 forUS Core Direct email Extension (FHIR-26459)
    • Change valueQuantity min from 1 to 0 for US Core Pediatric BMI for Age Observation Profile and US Core Pediatric Weight for Height Observation Profile (FHIR-26363)
    • Add page contents to Clinical Notes and Basic Provenance pages (FHIR-25785)
    • Fix duplicate URL causing validation failure. (FHIR-25536)
    • Fix Invariant us-core-8 (FHIR-25459)
    • Corrected the wording should support to shall support in Clinical Notes Guidance (FHIR-25455)
    • Fix Invariant us-core-8 to allow for Data Absent Reason Extension on Patient name.(FHIR-25249)
    • Fix Link to LOINC LP29708-2 (FHIR-25213)
    • Corrected guidance for conveying Patient-Reported medications (FHIR-25035)

STU4 Release for FHIR R4 (v4.0.0)

STU 4 (v4.0.0)

  • Created negation profiles
  • Added patterns pages and CQL examples
  • Corrections throughout
  • Updated QDM-to-QI-Core mapping
  • Added negation reason value set and bindings

STU4 Ballot for FHIR R4 (v3.3.0)

STU 4 Ballot (v3.3.0)

  • Updated profiles to be based on FHIR R4 and US Core STU 3
  • #22645 Added profiles on Immunization and Evaluation
  • #15012 Added a profile on NutritionOrder
  • #20727 Updated Observation documentation to provide clarity on use of FHIR and US Core profiles
  • #20610 Created the notDone extension and modified the DeviceUseStatement profile to use it; added the DeviceRequest profile, use the doNotPerform extension
  • #22646 Relaxed Must Support requirement on some fields of Immunization and ImmunizationRecommendation profiles
  • #14991 Added an example of using body position with an Observation

STU3.2 Release for FHIR STU3 (v3.2.0)

STU 3.2 (v3.2.0)

  • Updated profiles to be based on US Core 2.0.0
  • Derived Encounter and PractitionerRole profiles from US Core profiles

STU3 Release for FHIR STU3 (v3.1.0)

STU 3 (v3.1.0)

  • Added profile for PractitionerRole and removed Practitioner.role extension
  • Added profile for Task
  • Established pattern for representing QDM Principal Diagnosis in Encounters
  • Relaxed conformance requirements from all profiles to profiles that are relevant to a particular use case

STU3 Ballot for FHIR STU3 (v2.1.0)

STU 3 Ballot (v3.0.0)

  • Incorporates ballot reconciliation from all comments from the September 2016 ballot which have been applied to FHIR 3.0 and US Core Release 1.0.1
  • Includes mapping to QDM Version 5.3 Annotated available at: https://ecqi.healthit.gov/qdm
  • Includes an updated Mapping table from the QI-Core metadata to QDM 5.3
  • Includes a direct mapping from QDM version 5.3 to QI Core

STU2 Release for FHIR STU3 (v2.0.0)

STU 2 (v2.0.0)

  • Updated to FHIR STU3 (3.0.1)
  • Changed from Universal Realm to US Realm
  • Derived from US Core profiles where possible
  • Added support for Claim and Coverage resources
  • Changed AdverseEvent profile to use the base resource
  • Numerous typographical and technical errors corrected

STU2 Ballot for FHIR STU3 Ballot (v1.6.0)

STU 2 Ballot

  • Moved out of main FHIR publication package to its own home
  • Updated QI-Core profiles for changes to underlying specification
  • Added an additional profile on Condition
  • The QUICK logical model is included

STU1 Release for FHIR DSTU2 (v1.0.2)

DSTU 1 (Permanent home)

DSTU1 Preview for FHIR STU1 (v1.0.0)”

DSTU1 Preview

DSTU1 Ballot for FHIR STU1 (v0.5.0)

DSTU1 Ballot