QI-Core Implementation Guide: STU 3.2 (v3.2.0 for FHIR 3.0.1)

This page is part of the Quality Improvement Core Framework (v3.2.0: STU 3) based on FHIR R3. The current version which supercedes this version is 4.1.1. For a full list of available versions, see the Directory of published versions

7.17.0 Participation

The CQI Workgroup reviewed this content in April 2018 based on QDM version 5.3. There are no changes required based on QDM version 5.4.

QDM defines Participation as a patient’s coverage by a program such as an insurance or medical plan or a payment agreement. Such programs can include patient-centered medical home, disease-specific programs, etc. Definitions modeled similar to HL7 FHIR STU 3.0 - https://www.hl7.org/fhir/coverage.html.

QDM Attribute QI Core Metadata Element Comment
Participation Coverage (the .status metadata allows conformance to the specific QDM datatype context) QDM matched to FHIR / QI Core
Code Coverage.type Modeled with FHIR Resource Coverage - may not apply to non-financial program participation but there is no other clear option identified. Not in QI Core
Participation Period Coverage.period QDM matched to FHIR / QI Core
id Coverage.id QDM matched to FHIR / QI Core