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