US Situational Awareness Framework for Reporting (US SAFR) Implementation Guide
1.0.0-ballot - STU 1 ballot United States of America flag

This page is part of the US Situational Awareness Framework for Reporting (US SAFR) Implementation Guide (v1.0.0-ballot: STU 1 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. No current official version has been published yet. 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.

Behavior: Capability Statements

The following artifacts define the specific capabilities that different types of systems are expected to have in order to comply with this implementation guide. Systems conforming to this implementation guide are expected to declare conformance to one or more of the following capability statements.

US SAFR Data Aggregator CapabilityStatement

This statement defines the expected capabilities of a system that aggregates data from multiple Data Source actors before measure evaluation and then plays the role of a Data Source once aggregation is complete. An example would be a state public health agency aggregating data from all facilities in the state before using those data to produce a MeasureReport containing bed capacity data for the entire state. When FHIR enabled, a Data Aggregator acts as a US Core Server when playing the role of a Data Source after aggregation. During aggregation, the Data Aggregator acts similar to the SANER options for aggregation, but implements its own CapabilityStatement due to the incompatibilities between DEQM and SANER.

US SAFR Data Evaluation Engine CapabilityStatement

This statement defines the expected capabilities of a system that retrieves data from the Data Source and evaluates those data against one or more measures retrieved from the Measure Source. The resulting MeasureReport bundle and related resources are then sent to the MeasureReport recipient The dQM Evaluation Engine acts as a US Core Client, a DEQM Reporter Client, and implements the $evaluation-measure operation

US SAFR Data Source CapabilityStatement

This statement defines the expected capabilities of a system containing data (typically patient data, but could be situational awareness data) that will be evaluated against one or more measures. This may be a FHIR server, an EHR with a FHIR endpoint (facade), an internal data store when the Data Source and dQM Evaluation Engine actors are played by the same system such as an EHR that does it’s own measure evaluation, or it may be a system containing other data such as situational awareness data that is reporting via CSV or other format. When FHIR enabled, the Data Source acts as a US Core Server

US SAFR Measure Source CapabilityStatement

This statement defines the expected capabilities of a system at NHSN that stores FHIR resources such as Measure, Library, ValueSet, etc. that are used for dQM Reporting. The dQM Evaluation Engine queries the Measure Source for the latest Measure content before querying the Patient Data Source and performing measure evaluation. The Measure Source acts as a CQFM Publishable Measure Repository.

US SAFR MeasureReport Recipient CapabilityStatement

This statement defines the expected capabilities of a system at NHSN that receives MeasureReport bundles from the dQM Evaluation Engine and validates the result against the profiles in this implementation guide, and potentially other measure-specific profiles that are distributed with the measures themselves (this kind of validation is referred to as “pre-qualification” at NHSN). The MeasureReport Recipient acts as a DEQM Receiver Server, provides write access to Bundle resources containing MeasureReport and other related resources, and implements the $validate operation.

Structures: Resource Profiles

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

US SAFR Measure Bundle

This profile defines a Bundle provided by the MeasureServer containing a Measure resource and enables the inclusion of all related resources (ValueSet, Library, etc.).

US SAFR Measure Report Bundle

This profile defines a valid submission bundle to NHSN with all resources contained within. The Bundle is comprised of entry slices representing the data submitting organization, submitting device, and individual MeasureReports.

US SAFR Submitting Organization

This profile includes the name and identifier of the organization submitting the report Bundle, and may include other information about the organization.

Terminology: Code Systems

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

Healthcare Capacity Reporting Code System

This CodeSystem defines coded concepts for Healthcare Capacity reporting to US SAFR. This is an example CodeSystem and is experimental, and is expected to be replaced by LOINC codes once they have been assigned.

Healthcare Capacity Reporting Group Code System

This CodeSystem defines coded concepts for Healthcare Capacity Group reporting to US SAFR. This is an example CodeSystem and is experimental, and is expected to be replaced by LOINC codes once they have been assigned.

Hospital Respiratory Data Reporting Code System

This CodeSystem defines coded concepts for Hospital Respiratory Data reporting for US SAFR IG. This is an example CodeSystem and is experimental, and is expected to be replaced by LOINC codes once they have been assigned.

Hospital Respiratory Data Supply Days Code System

This CodeSystem defines coded concepts for supply days in Hospital Respiratory Data reporting for US SAFR IG. This is an example CodeSystem and is experimental, and is expected to be replaced when a permanent location is identified.

Example: Example Instances

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

Bundle - Bed Capacity Measure Bundle Example

This Bundle resource is an example of a Bed Capacity Measure Bundle.

Bundle - Bed Capacity Report Bundle Example

Bundle containing a measure report and all referenced resources for NHSN bed capacity reporting.

Bundle - HRD Measure Bundle Example

This Bundle resource is an example of a Hospital Respiratory Data (HRD) Measure Bundle.

Bundle - HRD Measure Report Bundle Example

Bundle containing a measure report and all referenced resources for NHSN Hospital Respiratory Disease (HRD) reporting

Device - CQF Tooling System Example

Example of a Software System Device instance for describing tooling that was used to process artifacts.

Library - HRD Measure Example

This library contains CQL logic for evaluating structural measures related to hospital respiratory disease reporting capabilities

Library - Library of Bed Capacity Measure Example

This library contains CQL logic for evaluating structural measures related to bed capacity reporting capabilities.

Measure - Bed Capacity Measure Example

Example of a bed capacity measure for ICU, ED, and Pediatric beds for NHSN reporting.

Measure - HRD Measure Example

Example of a Hospital Respiratory Disease (HRD) Measure for NHSN reporting.

MeasureReport - Bed Capacity MeasureReport Example

Example MeasureReport for NHSN bed capacity monitoring showing ICU, ED, and Pediatric bed capacity

MeasureReport - HRD MeasureReport Example

This Bundle resource is an example of a Hospital Respiratory Data (HRD) MeasureReport.

Organization - Submitting Hospital Organization Example

Organization - Example of a Submitting Hospital Organization