Model definition for the QI-Core IG Model

An adverse event (AE) 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.

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

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

The QI-Core CarePlan is based upon the US Core CarePlan Profile which is based upon the core FHIR CarePlan Resource and created to meet the 2015 Edition Common Clinical Data Set ‘Assessment and Plan of Treatment requirements. Defines constraints and extensions on the CarePlan resource for the minimal set of data to query and retrieve a patient’s Care Plan.

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

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

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

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

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

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

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.

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

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

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

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

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

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

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.

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.

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

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

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

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

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

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

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

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

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

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.

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

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

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

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

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

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

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

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

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

Profile of NonPatient Observation for decision support/quality metrics evaluating resource use and availability rather than focusing on patients. Defines the core set of elements and extensions for quality rule and measure authors.

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

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

The QI-Core Observation Clinical Result Profile is based upon the US Core Observation Clinical Result Profile. Clinical results 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 Result Profile profile defines the core set of elements and extensions for quality rule and measure authors.

The QI-Core Observation Screening Assessment Profile is based upon the US Core Observation Screening Assessment 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 defines the core set of elements and extensions for quality rule and measure authors.

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

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

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

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

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

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

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.

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

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

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

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

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

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

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

This extension is only used in the QI-Core Implementation Guide’s Profile StructureDefinition elements. It flags elements that the quality improvement community has identified as significant to express the full intent of measures or decision support artifacts. See the MustSupport Flag section in this IG for more information.

The appropriateness score for the requested action.

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

Indicates the reason the event was not performed.

Indicates whether this is an elective procedure.

Indicates the reason the event was not done.

Captures the recorded date of the event.

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.

This value set defines the set of codes that indicate a non-negated event status (i.e. codes that are not not-done)

This value set defines the set of codes that indicate a non-negated event status for immunization resources (i.e. codes that are not not-done)

This value set defines the set of codes that indicate a non-negated medication administration status (i.e. codes that are not not-done)

This value set defines the set of codes that indicate a non-negated medication dispense status (i.e. codes that are not declined)

This value set defines the set of codes that indicate a non-negated observation status (i.e. codes that are not cancelled)

This value set defines the set of codes that indicate a non-negated task status (i.e. codes that are not rejected)

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

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

Value Set for QICore Present On Admission.

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

Example of a 10 minute Apgar Heart Rate Observation Screening Assessment

65+ Female patient example

Example of an allergic reaction adverse event

Example of a clinical assessment record of an allergy

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

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

Example of an assessment and care plan for a pregnancy

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

Example of a vision claim

Example of a vision claim response

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

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

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

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

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

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

Example of a coverage resource used to provide information about an individual’s specific plan

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

Example of a obstetric delivery datetime Observation

Example of a delivery date estimate Observation

Device example for an ECG

Request to employ a medical device

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

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

Example of a record of device use by a patient

Example of the findings and interpretation of a laboratory diagnostic test

Example of a DiagnosticReport Note

Example of an Encounter

Encounter example of emergency visit that escalated into inpatient patient

Example of Family Member History for a patient

Warning/Notification when providing care example

Example of a frailty observation measure

Example of a gestation age at birth observation

Example of a glucose laboratory result observation

Example of weight loss goal/objective for a patient

Example of a Heart rate rhythm clinical result observation

Example of hempdialysis machine availability nonpatient observation

Example of hospital bed availability nonpatient observation

Hendricks County Hospital example

Example of ImagingStudy based on CT imaging study

Immunization example

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

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

Example of ImmunizationEvaluation

Example of ImmunizationRecommendation for Hepatitis A vaccine

Infant patient example

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

Example of mechanical ventilator availability nonpatient observation

Example of Alemtuzumab Medication

Cumulative Medication example of MedicationAdministration

Intravenous example of MedicationAdministration

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

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

Cumulative Medication Dispense Example

Penicillin MedicationDispense Example

Example of medication not dispensed using a value set to indicate the reason

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

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

Example of medication not requested using a value set to indicate the reason

Cumulative Medication Duration Example

Patient Reported Example

Patient Requester Example

Practitioner Ordered Example

Penicillin MedicationRequest Example

Penicillin MedicationStatement Example

Example number of full-term births Observation

Example number of parity Observation

Example number of pregnancies Observation

Example number of preterm births Observation

Example of NutrientOrder for diabetic diet

Example of occupational data added to observation measure

Example of Decreased Hemoglobin Observation

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

Example of observation not done using a value set to indicate the reason

HL7 Organization example

Example of a PHQ-9 Questionnaire Response

Basic Patient example

Referring Practitioner example

PractitionerRole example

Appendectomy Procedure example

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

Example of procedure not done using a value set to indicate the reason

Emergency contact example

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

Example of service not requested using a value set to indicate the reason

ServiceRequest for Myringotomy Procedure example

ServiceRequest appropriateness example

Elective procedure ServiceRequest example

Request for Appendectomy ServiceRequest example

Honey Bee venom (apitoxin) Substance example

Task example

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

Example of task not done using a value set to indicate the reason