Data Exchange For Quality Measures STU3 for FHIR R4
3.0.0 - STU 3

This page is part of the Da Vinci Data Exchange for Quality Measures (DEQM) FHIR IG (v3.0.0: STU 3) based on FHIR R4. The current version which supercedes this version is 3.1.0. For a full list of available versions, see the Directory of published versions

Resource Profile: DEQM Gaps In Care Detected Issue Profile

Defining URL:http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-detectedissue-deqm
Version:3.0.0
Name:DEQMGapsInCareDetectedIssueProfile
Title:DEQM Gaps In Care Detected Issue Profile
Status:Active as of 2021-04-23
Definition:

The DEQM Gaps In Care DetectedIssue Profile indicates that the measure reported has an open gap or a closed gap as identified in the gapStatus modifier extension.

Publisher:HL7 International - Clinical Quality Information Work Group
Source Resource:XML / JSON / Turtle

The official URL for this profile is:

http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-detectedissue-deqm

This profile builds on DetectedIssue.

Mandatory Data Elements and Terminology

The following data-elements are mandatory (i.e data MUST be present).

Each must have:

  1. A modifier extension: DEQMGapStatusModifierExtension.
  2. A DetectedIssue.code with a fixed code CAREGAP.
  3. The DetectedIssue.evidence.detail either references the measure to which the detected issue applies by referencing the DEQM Individual Measure Report or references the GuidanceResponse resource.
  4. A DetectedIssue.patient references the patient for which the detected issue applies.

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from DetectedIssue

Summary

Mandatory: 5 elements
Must-Support: 5 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

This structure is derived from DetectedIssue

NameFlagsCard.TypeDescription & Constraintsdoco
.. DetectedIssue 0..*DetectedIssueClinical issue with action
... modifierExtension:gapStatus ?!S1..1DEQMGapStatusModifierExtensionGap Status
... code S1..1CodeableConceptIssue Category, e.g. drug-drug, duplicate therapy, etc.
Fixed Value: As shown
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: CAREGAP
..... display1..1stringRepresentation defined by the system
Fixed Value: Care Gaps
... patient S1..1Reference(QICorePatient)Associated patient
... evidence S1..*BackboneElementSupporting evidence
.... detail S1..1Reference(DEQM Individual MeasureReport Profile | GuidanceResponse)This references either a DEQM Individual MeasureReport or a GuidanceResponse resource. Note that referencing the GuidanceResponse resource allows potential profiling on GuidanceResponse in the future without breaking backward compatibility.

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. DetectedIssue 0..*DetectedIssueClinical issue with action
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages: A human language.

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... Slices for modifierExtension ?!0..*ExtensionExtension
Slice: Unordered, Open by value:url
... modifierExtension:gapStatus ?!S1..1DEQMGapStatusModifierExtensionGap Status
... identifier Σ0..*IdentifierUnique id for the detected issue
... status ?!Σ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required): Indicates the status of the identified issue.

... code SΣ1..1CodeableConceptIssue Category, e.g. drug-drug, duplicate therapy, etc.
Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc.


Fixed Value: As shown
.... id0..0stringUnique id for inter-element referencing
.... extension0..0ExtensionAdditional content defined by implementations
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..0stringUnique id for inter-element referencing
..... extension0..0ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode
..... version0..0stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: CAREGAP
..... display1..1stringRepresentation defined by the system
Fixed Value: Care Gaps
..... userSelected0..0booleanIf this coding was chosen directly by the user
.... text0..0stringPlain text representation of the concept
... severity Σ0..1codehigh | moderate | low
Binding: DetectedIssueSeverity (required): Indicates the potential degree of impact of the identified issue on the patient.

... patient SΣ1..1Reference(QICorePatient)Associated patient
... identified[x] Σ0..1When identified
.... identifiedDateTimedateTime
.... identifiedPeriodPeriod
... author Σ0..1Reference(Practitioner | PractitionerRole | Device)The provider or device that identified the issue
... implicated Σ0..*Reference(Resource)Problem resource
... evidence S1..*BackboneElementSupporting evidence
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code 0..*CodeableConceptManifestation
Binding: ManifestationAndSymptomCodes (example): Codes that describes the types of evidence for a detected issue.


.... detail S1..1Reference(DEQM Individual MeasureReport Profile | GuidanceResponse)This references either a DEQM Individual MeasureReport or a GuidanceResponse resource. Note that referencing the GuidanceResponse resource allows potential profiling on GuidanceResponse in the future without breaking backward compatibility.
... detail 0..1stringDescription and context
... reference 0..1uriAuthority for issue
... mitigation 0..*BackboneElementStep taken to address
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... action 1..1CodeableConceptWhat mitigation?
Binding: DetectedIssueMitigationAction (preferred): Codes describing steps taken to resolve the issue or other circumstances that mitigate the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy documented', etc.

.... date 0..1dateTimeDate committed
.... author 0..1Reference(Practitioner | PractitionerRole)Who is committing?

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. DetectedIssue 0..*DetectedIssueClinical issue with action
... modifierExtension:gapStatus ?!1..1DEQMGapStatusModifierExtensionGap Status
... code Σ1..1CodeableConceptIssue Category, e.g. drug-drug, duplicate therapy, etc.
Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc.


Fixed Value: As shown
.... id0..0stringUnique id for inter-element referencing
.... extension0..0ExtensionAdditional content defined by implementations
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..0stringUnique id for inter-element referencing
..... extension0..0ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode
..... version0..0stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: CAREGAP
..... display1..1stringRepresentation defined by the system
Fixed Value: Care Gaps
..... userSelected0..0booleanIf this coding was chosen directly by the user
.... text0..0stringPlain text representation of the concept
... patient Σ1..1Reference(QICorePatient)Associated patient
... evidence 1..*BackboneElementSupporting evidence
.... detail 1..1Reference(DEQM Individual MeasureReport Profile | GuidanceResponse)This references either a DEQM Individual MeasureReport or a GuidanceResponse resource. Note that referencing the GuidanceResponse resource allows potential profiling on GuidanceResponse in the future without breaking backward compatibility.

doco Documentation for this format

This structure is derived from DetectedIssue

Summary

Mandatory: 5 elements
Must-Support: 5 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Differential View

This structure is derived from DetectedIssue

NameFlagsCard.TypeDescription & Constraintsdoco
.. DetectedIssue 0..*DetectedIssueClinical issue with action
... modifierExtension:gapStatus ?!S1..1DEQMGapStatusModifierExtensionGap Status
... code S1..1CodeableConceptIssue Category, e.g. drug-drug, duplicate therapy, etc.
Fixed Value: As shown
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: CAREGAP
..... display1..1stringRepresentation defined by the system
Fixed Value: Care Gaps
... patient S1..1Reference(QICorePatient)Associated patient
... evidence S1..*BackboneElementSupporting evidence
.... detail S1..1Reference(DEQM Individual MeasureReport Profile | GuidanceResponse)This references either a DEQM Individual MeasureReport or a GuidanceResponse resource. Note that referencing the GuidanceResponse resource allows potential profiling on GuidanceResponse in the future without breaking backward compatibility.

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. DetectedIssue 0..*DetectedIssueClinical issue with action
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages: A human language.

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... Slices for modifierExtension ?!0..*ExtensionExtension
Slice: Unordered, Open by value:url
... modifierExtension:gapStatus ?!S1..1DEQMGapStatusModifierExtensionGap Status
... identifier Σ0..*IdentifierUnique id for the detected issue
... status ?!Σ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required): Indicates the status of the identified issue.

... code SΣ1..1CodeableConceptIssue Category, e.g. drug-drug, duplicate therapy, etc.
Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc.


Fixed Value: As shown
.... id0..0stringUnique id for inter-element referencing
.... extension0..0ExtensionAdditional content defined by implementations
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..0stringUnique id for inter-element referencing
..... extension0..0ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode
..... version0..0stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: CAREGAP
..... display1..1stringRepresentation defined by the system
Fixed Value: Care Gaps
..... userSelected0..0booleanIf this coding was chosen directly by the user
.... text0..0stringPlain text representation of the concept
... severity Σ0..1codehigh | moderate | low
Binding: DetectedIssueSeverity (required): Indicates the potential degree of impact of the identified issue on the patient.

... patient SΣ1..1Reference(QICorePatient)Associated patient
... identified[x] Σ0..1When identified
.... identifiedDateTimedateTime
.... identifiedPeriodPeriod
... author Σ0..1Reference(Practitioner | PractitionerRole | Device)The provider or device that identified the issue
... implicated Σ0..*Reference(Resource)Problem resource
... evidence S1..*BackboneElementSupporting evidence
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code 0..*CodeableConceptManifestation
Binding: ManifestationAndSymptomCodes (example): Codes that describes the types of evidence for a detected issue.


.... detail S1..1Reference(DEQM Individual MeasureReport Profile | GuidanceResponse)This references either a DEQM Individual MeasureReport or a GuidanceResponse resource. Note that referencing the GuidanceResponse resource allows potential profiling on GuidanceResponse in the future without breaking backward compatibility.
... detail 0..1stringDescription and context
... reference 0..1uriAuthority for issue
... mitigation 0..*BackboneElementStep taken to address
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... action 1..1CodeableConceptWhat mitigation?
Binding: DetectedIssueMitigationAction (preferred): Codes describing steps taken to resolve the issue or other circumstances that mitigate the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy documented', etc.

.... date 0..1dateTimeDate committed
.... author 0..1Reference(Practitioner | PractitionerRole)Who is committing?

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSet / Code
DetectedIssue.languagepreferredCommonLanguages
Max Binding: AllLanguages
DetectedIssue.statusrequiredObservationStatus
DetectedIssue.codepreferredFixed Value: CAREGAP("Care Gaps")
DetectedIssue.severityrequiredDetectedIssueSeverity
DetectedIssue.evidence.codeexampleManifestationAndSymptomCodes
DetectedIssue.mitigation.actionpreferredDetectedIssueMitigationAction