Situational Awareness for Novel Epidemic Response
1.0.0 - STU Release
Situational Awareness for Novel Epidemic Response
1.0.0 - STU Release
This page is part of the Situational Awareness for Novel Epidemic Response (v1.0.0: STU 1) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions 
{
"resourceType" : "Measure",
"id" : "PatientsByRiskFactorWithSupplementalData",
"meta" : {
"profile" : [
"http://hl7.org/fhir/uv/saner/StructureDefinition/PublicHealthMeasure"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>Enables specification of proposed measure reporting</b>: Do Once per 1 days</p><p><b>url</b>: <code>http://hl7.org/fhir/uv/saner/Measure/PatientsByRiskFactorWithSupplementalData</code></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: PatientsByRiskFactor</p><p><b>title</b>: COVID-19 Patients By Risk Factor</p><p><b>status</b>: draft</p><p><b>experimental</b>: true</p><p><b>date</b>: Sep 7, 2021 7:08:29 PM</p><p><b>publisher</b>: HL7 International Public Health Workgroup</p><p><b>contact</b>: <a href=\"http://hl7.org/Special/committees/pher\">http://hl7.org/Special/committees/pher</a>, <a href=\"mailto:pher@lists.hl7.org\">pher@lists.hl7.org</a>, Keith W. Boone: <a href=\"mailto:mailto:kboone@ainq.com\">mailto:kboone@ainq.com</a></p><p><b>jurisdiction</b>: <span title=\"Codes: {http://unstats.un.org/unsd/methods/m49/m49.htm 001}\">World</span></p><p><b>author</b>: Centers for Disease Control/National Healthcare Safety Network (CDC/NHSN): <a href=\"mailto:mailto:nhsn@cdc.gov\">mailto:nhsn@cdc.gov</a></p><p><b>library</b>: <a href=\"http://hl7.org/fhir/uv/saner/Library/ComputableNHSNMeasureLibrary\">http://hl7.org/fhir/uv/saner/Library/ComputableNHSNMeasureLibrary</a></p><blockquote><p><b>group</b></p><blockquote><p><b>Attributes describing a group of measures</b></p><p><b>value</b>: <span title=\"Codes: {http://hl7.org/fhir/resource-types Encounter}, {http://snomed.info/sct 398284004}\">Patient in room</span></p><p><b>value</b>: <span title=\"Codes: {http://hl7.org/fhir/uv/saner/CodeSystem/PublicHealthMeasureScoring queue-length}\">Queue Length</span></p><p><b>value</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-type structure}\">Structure</span></p><p><b>value</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-improvement-notation decrease}\">Decreased score indicates improvement</span></p><p><b>value</b>: point-in-time</p></blockquote><p><b>code</b>: <span title=\"Codes: {http://hl7.org/fhir/uv/saner/CodeSystem/MeasureGroupSystem Encounters}\">Hospital COVID-19 Patient Encounters Reporting</span></p><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://hl7.org/fhir/uv/saner/CodeSystem/MeasuredValues confirmedC19Pats}, {http://terminology.hl7.org/CodeSystem/measure-population initial-population}\">Patients with confirmed COVID-19 in any location.</span></p><p><b>description</b>: Active encounters where the encounter diagnosis is suspected or confirmed COVID-19,\nor a Condition of confirmed COVID-19 was created during that encounter. This includes the patients with laboratory-confirmed\nor clinically diagnosed COVID-19.</p></blockquote><blockquote><p><b>stratifier</b></p><p><b>code</b>: <span title=\"Codes: \">By Risk Factor</span></p><p><b>description</b>: Stratifies the population by Condition/RiskFactor</p></blockquote></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: <span title=\"Codes: {http://hl7.org/fhir/resource-types Encounter}\">Encounter</span></p><p><b>usage</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span></p><p><b>description</b>: The patient encounter</p></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: <span title=\"Codes: {http://hl7.org/fhir/resource-types Patient}\">Patient</span></p><p><b>usage</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span></p><p><b>description</b>: The patient</p></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: <span title=\"Codes: {http://hl7.org/fhir/resource-types Location}\">Location</span></p><p><b>usage</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span></p><p><b>description</b>: The patient location</p></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: <span title=\"Codes: {http://hl7.org/fhir/resource-types Condition}\">Condition</span></p><p><b>usage</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span></p><p><b>description</b>: The encounter and other diagnosis</p></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: <span title=\"Codes: {http://hl7.org/fhir/resource-types MedicationRequest}, {http://hl7.org/fhir/resource-types MedicationAdministration}, {http://hl7.org/fhir/resource-types Immunization}\">MedicationRequest</span></p><p><b>usage</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span></p><p><b>description</b>: Medications/Immunizations given during the encounter</p></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: <span title=\"Codes: {http://hl7.org/fhir/resource-types Observation}\">Observation</span></p><p><b>usage</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span></p><p><b>description</b>: COVID-19 Lab Results</p></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: <span title=\"Codes: {http://hl7.org/fhir/resource-types DiagnosticReport}, {http://hl7.org/fhir/resource-types DocumentReference}, {http://hl7.org/fhir/resource-types Observation}, {http://hl7.org/fhir/resource-types ServiceRequest}\">DiagnosticReport</span></p><p><b>usage</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span></p><p><b>description</b>: VTE Diagnostic Results</p></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: <span title=\"Codes: {http://hl7.org/fhir/resource-types Procedure}, {http://hl7.org/fhir/resource-types ServiceRequest}\">Procedure</span></p><p><b>usage</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span></p><p><b>description</b>: Isolation Precautions</p></blockquote></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/uv/saner/StructureDefinition/ReportingPeriod",
"valueTiming" : {
"repeat" : {
"frequency" : 1,
"period" : 1,
"periodUnit" : "d"
}
}
}
],
"url" : "http://hl7.org/fhir/uv/saner/Measure/PatientsByRiskFactorWithSupplementalData",
"version" : "1.0.0",
"name" : "PatientsByRiskFactor",
"title" : "COVID-19 Patients By Risk Factor",
"status" : "draft",
"experimental" : true,
"date" : "2021-09-07T19:08:29+00:00",
"publisher" : "HL7 International Public Health Workgroup",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "http://hl7.org/Special/committees/pher"
}
]
},
{
"telecom" : [
{
"system" : "email",
"value" : "pher@lists.hl7.org"
}
]
},
{
"name" : "Keith W. Boone",
"telecom" : [
{
"system" : "email",
"value" : "mailto:kboone@ainq.com"
}
]
}
],
"useContext" : [
{
"code" : {
"system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code" : "focus"
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "840539006",
"display" : "COVID-19"
}
]
}
}
],
"jurisdiction" : [
{
"coding" : [
{
"system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
"code" : "001"
}
]
}
],
"author" : [
{
"name" : "Centers for Disease Control/National Healthcare Safety Network (CDC/NHSN)",
"telecom" : [
{
"system" : "email",
"value" : "mailto:nhsn@cdc.gov"
}
]
}
],
"relatedArtifact" : [
{
"type" : "documentation",
"label" : "NHSN COVID-19 Reporting",
"display" : "CDC/NHSN COVID-19 Patient Impact & Hospital Capacity Module Home Page",
"url" : "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/acute-care-hospital/covid19/"
},
{
"type" : "documentation",
"label" : "How to import COVID-19 Summary Data",
"display" : "Importing COVID-19 Patient Module Denominator data for Patient Safety Component",
"url" : "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/import-covid19-data-508.pdf"
},
{
"type" : "documentation",
"label" : "Table of Instructions",
"display" : "Instructions for Completion of the COVID-19 Patient Impact and Hospital Capacity Module Form (CDC 57.130)",
"url" : "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/57.130-toi-508.pdf"
},
{
"type" : "documentation",
"label" : "CSV File Template",
"display" : "CDC/NHSN COVID-19 Reporting CSV File Template",
"url" : "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/covid19-test-csv-import.csv"
}
],
"library" : [
"http://hl7.org/fhir/uv/saner/Library/ComputableNHSNMeasureLibrary"
],
"group" : [
{
"extension" : [
{
"extension" : [
{
"url" : "subject",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/resource-types",
"code" : "Encounter"
},
{
"system" : "http://snomed.info/sct",
"code" : "398284004",
"display" : "Patient in room"
}
],
"text" : "Patient in room"
}
},
{
"url" : "scoring",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/uv/saner/CodeSystem/PublicHealthMeasureScoring",
"code" : "queue-length"
}
]
}
},
{
"url" : "type",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-type",
"code" : "structure"
}
]
}
},
{
"url" : "improvementNotation",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code" : "decrease"
}
]
}
},
{
"url" : "rateAggregation",
"valueString" : "point-in-time"
}
],
"url" : "http://hl7.org/fhir/uv/saner/StructureDefinition/MeasureGroupAttributes"
}
],
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/uv/saner/CodeSystem/MeasureGroupSystem",
"code" : "Encounters",
"display" : "Encounters"
}
],
"text" : "Hospital COVID-19 Patient Encounters Reporting"
},
"population" : [
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/uv/saner/CodeSystem/MeasuredValues",
"code" : "confirmedC19Pats",
"display" : "All Confirmed COVID-19 Patients"
},
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population"
}
],
"text" : "Patients with confirmed COVID-19 in any location."
},
"description" : "Active encounters where the encounter diagnosis is suspected or confirmed COVID-19,\nor a Condition of confirmed COVID-19 was created during that encounter. This includes the patients with laboratory-confirmed\nor clinically diagnosed COVID-19.",
"criteria" : {
"description" : "This expression finds encounters that were active or finished in the reporting period, and their referenced Patient, Condition\nand Observation resources. It filters these based on cases where Encounter reports a reason or condition in the\nConfirmedCOVID19Diagnoses value set, or where a positive lab test from the Covid19Labs valueset, or where the patient\nhas any such associated Condition or Observation resources in the prior two weeks.",
"name" : "ConfirmedC19Pats",
"language" : "text/fhirpath",
"expression" : "findAll('Encounter',\n including('subject','condition','reasonReference'),\n with('status').equalTo('in-progress,finished'),\n with('date').within(%ReportingPeriod)\n ).onServers(%Base).\n where(\n iif(\n (Encounter.reasonCode | Condition.code).member0f(%ConfirmedCOVID19Diagnoses.url) |\n Observation.where(code.member0f(%Covid19Labs.url) and value.member0f(%PositiveResults.url)),\n true,\n iif(\n Patient.distinct()\n .whereExists('Observation',\n for('patient', $this.id),\n with('status').equalTo(\n 'registered,preliminary,final,amended,corrected'),\n with('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n with('code').in(%Covid19Labs),\n with('value-concept').in(%PositiveResults)\n ).onServers(%Base),\n true,\n Patient.distinct()\n .whereExists('Condition',\n for('patient', $this.id),\n with('verification-status').notEqualTo('refuted,entered-in-error').\n with('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n with('code').in(%ConfirmedCOVID19Diagnoses.url)\n ).onServers(%Base)\n )\n )\n)\n.ofType(Encounter)\n.distinct()\n.aggregate(\n iif($total.subject contains $this.subject, $total, $total | $this )\n)"
}
}
],
"stratifier" : [
{
"code" : {
"text" : "By Risk Factor"
},
"description" : "Stratifies the population by Condition/RiskFactor",
"criteria" : {
"description" : "Final all conditions for each patient in the AllCOVID19RiskFactors ValueSet\nand stratify by membership in subsets of that value set. NOTE: A patient\ncan belong to multiple strata in this example.",
"language" : "text/fhirpath",
"expression" : "findAll('Condition',\n\tfor('patient', $this.subject),\n\twith('code').in(%AllCOVID19RiskFactors.url),\n with('onset-date').greaterThan(%ReportingPeriod.start - 1 'year')\n ).onServers(%Base).select(\n \tiif(code.member0f(%NeoplasticCOVID19RiskFactors.url), 'Neoplastic Disease', {}) |\n \tiif(code.member0f(%COPDCOVID19RiskFactors.url), 'COPD', {}) |\n \tiif(code.member0f(%TobaccoCOVID19RiskFactors.url), 'Tobacco User', {}) |\n \tiif(code.member0f(%HypertensionCOVID19RiskFactors.url), 'Hypertension', {}) |\t// Calling out Hypertension separately for reasons\n \tiif(code.member0f(%CardiovascularCOVID19RiskFactors.url), 'Cardiovascular Disease', {}) |\t// Even though it isa Cardiovascular disease\n \tiif(code.member0f(%ObesityCOVID19RiskFactors.url), 'Obesity', {}) |\n \tiif(code.member0f(%SickleCellCOVID19RiskFactors.url), 'Sickle cell Disease', {}) |\n \tiif(code.member0f(%KidneyDiseaseCOVID19RiskFactors.url), 'Chronic Kidney Disease', {}) |\n \tiif(code.member0f(%PregnancyCOVID19RiskFactors.url), 'Pregnant', {}) |\n \tiif(code.member0f(%DiabetesCOVID19RiskFactors.url), 'Diabetes', {})\n )"
}
}
]
}
],
"supplementalData" : [
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/resource-types",
"code" : "Encounter"
}
]
},
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "The patient encounter",
"criteria" : {
"description" : "Encounter dates, reason (e.g., Chief Complaint), discharge disposition",
"name" : "Encounter",
"language" : "text/fhirpath",
"expression" : "Encounter"
}
},
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/resource-types",
"code" : "Patient"
}
]
},
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "The patient",
"criteria" : {
"description" : "The Patient, including sex, dob, race and ethnicity",
"name" : "Patient",
"language" : "text/fhirpath",
"expression" : "Encounter.subject.resolve()"
}
},
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/resource-types",
"code" : "Location"
}
]
},
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "The patient location",
"criteria" : {
"description" : "The Patient Location",
"name" : "PatientLocation",
"language" : "text/fhirpath",
"expression" : "Encounter.location.location.resolve()"
}
},
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/resource-types",
"code" : "Condition"
}
]
},
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "The encounter and other diagnosis",
"criteria" : {
"description" : "Retrieves all conditions associated with the encounter",
"name" : "EncounterDiagnosis",
"language" : "text/fhirpath",
"expression" : "(Encounter.reasonReference|Encounter.diagnosis.condition).resolve() |\nfindAll('Condition',\n\tfor('patient', $this.subject),\n\twith('encounter').equalTo($this.id)\n).onServers(%Base)"
}
},
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/resource-types",
"code" : "MedicationRequest"
},
{
"system" : "http://hl7.org/fhir/resource-types",
"code" : "MedicationAdministration"
},
{
"system" : "http://hl7.org/fhir/resource-types",
"code" : "Immunization"
}
]
},
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "Medications/Immunizations given during the encounter",
"criteria" : {
"description" : "Retrieves all medications/immunizations associated with the encounter",
"name" : "EncounterMeds",
"language" : "text/fhirpath",
"expression" : "findAll('MedicationRequest',\n\tfor('patient', $this.subject),\n\twith('encounter').equalTo($this.id) // alternately, this could be within encounter dates\n).onServers(%Base) |\nfindAll('MedicationAdministration',\n\tfor('patient', $this.subject),\n\twith('effective-time').within(%ReportingPeriod)\n).onServers(%Base) |\nfindAll('Immunization',\n\tfor('patient', $this.subject),\n\twith('date').within(%ReportingPeriod)\n).onServers(%Base)"
}
},
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/resource-types",
"code" : "Observation"
}
]
},
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "COVID-19 Lab Results",
"criteria" : {
"description" : "Retrieves all Observations associated with COVID-19 Labs",
"name" : "COVID19Labs",
"language" : "text/fhirpath",
"expression" : "findAll('Observation',\n\tfor('patient', $this.subject),\n\twith('code').in(%Covid19Labs.url),\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year')\n).onServers(%Base)"
}
},
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/resource-types",
"code" : "DiagnosticReport"
},
{
"system" : "http://hl7.org/fhir/resource-types",
"code" : "DocumentReference"
},
{
"system" : "http://hl7.org/fhir/resource-types",
"code" : "Observation"
},
{
"system" : "http://hl7.org/fhir/resource-types",
"code" : "ServiceRequest"
}
]
},
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "VTE Diagnostic Results",
"criteria" : {
"description" : "Retrieves diagnostics associated with VTE",
"name" : "VTEDiagnostics",
"language" : "text/fhirpath",
"expression" : "findAll('DiagnosticReport',\n\tfor('patient', $this.subject),\n\tincluding('result', 'media'), // what else?\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n\twith('code').in(%VTEReports.url)\n).onServers(%Base) |\nfindAll('DocumentReference',\n\tfor('patient', $this.subject),\n\tincluding('related'), // what else?\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n\twith('type').in(%VTEReports.url)\n).onServers(%Base) |\nfindAll('Observation',\n\tfor('patient', $this.subject),\n\tincluding('based-on'), // what else?\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n\twith('code').in(%VTEReports.url)\n).onServers(%Base) |\nfindAll('ServiceRequest',\n\tfor('patient', $this.subject),\n\tincluding('based-on'), // what else?\n\twith('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n\twith('code').in(%VTEReports.url)\n).onServers(%Base)"
}
},
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/resource-types",
"code" : "Procedure"
},
{
"system" : "http://hl7.org/fhir/resource-types",
"code" : "ServiceRequest"
}
]
},
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "Isolation Precautions",
"criteria" : {
"description" : "Retrieves orders or procedures associated with Isolation Precautions",
"name" : "IsolationOrders",
"language" : "text/fhirpath",
"expression" : "findAll('ServiceRequest',\n\tfor('patient', $this.subject),\n\tfor('encounter', $this.id),\n\twith('code').in(%IsolationPrecautions.url)\n).onServers(%Base) |\nfindAll('Procedure',\n\tfor('patient', $this.subject),\n\tfor('encounter', $this.id),\n\twith('code').in(%IsolationPrecautions.url)\n).onServers(%Base)"
}
}
]
}
IG © 2020+ HL7 International Public Health Workgroup. Package hl7.fhir.uv.saner#1.0.0 based on FHIR 4.0.1. Generated 2021-09-07
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