Quality Improvement Core Framework (v3.3.0: STU 4 Ballot 1). The current version is 3.2.0 based on FHIR R4. See the Directory of published versions
This QDM to QI Core Mapping for the QDM Category "Assessment" was reviewed by the CQI WG on March 9, 2018 for QDM version 5.3 and updated to QDM 5.4 on June 7, 2018. QDM 5.4 added the QDM datatype "Assessment, Order" that was not present in QDM version 5.3. In QDM 5.4, the "method" attribute has been removed from "Assessment, Order" and "Assessment, Recommended" but is retained for "Assessment, Performed".
QDM defines Assessment as a resource used to define specific observations that clinicians use to guide treatment of the patient. An assessment can be a single question, or observable entity with an expected response, an organized collection of questions intended to solicit information from patients, providers or other individuals, or a single observable entity that is part of such a collection of questions. US-Core defines a specific resource for smoking status assessment; other observations that meet the QDM definition of assessment use the FHIR Observation resource:
QDM Context | QI-Core R4 | Comments |
Assessment, Performed | Observation | General Use Case |
Observation.category | Since Assessment is a broad concept, the measure developer will need to select the appropriate category. | |
Observation.status | Constrain status to - final, amended, corrected | |
QDM Attributes | ||
code | Observation.code | |
id | Observation.id | |
method | Observation.method | |
relatedTo | Observation.basedOn | |
Observation.partOf | A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure. | |
Observation.derivedFrom | ||
negation rationale | Observation.dataAbsentReason | Initial table indicates extensible but detailed link indicates SHALL - https://build.fhir.org/ig/HL7/US-Core-R4/StructureDefinition-us-core-observation-lab-definitions.html#Observation.dataAbsentReason |
reason | Observation.basedOn | The observation fulfills a plan, proposal or order - trace for authorization. Not a perfect fit for the intent in QDM (e.g., observation "reason" = a diagnosis) Is an extension needed? |
result | Observation.value[x] | |
Observation.interpretation | ||
Relevant dateTime | Observation.effective[x] dateTime | |
Relevant Period | Observation.effective[x] Period | |
Author dateTime | Observation.issued | Consider if authorDatetime (intended for negation rationale) fits with observation.issued or FHIR provenance for docuemtnation of the dataAbsentReason. |
Component | Observation.component | |
Observation.component.id | ||
Component code | Observation.component.code | |
Component Result | Observation.component.value[x] | |
Observation.component.interpretation | ||
Observation.component.dataAbsentReason | ||
Performer | Observation.performer |
QDM Context | USCore R4 | Comments |
Assessment, Performed: Smoking Status | Observation | Modeled as in USCore - Smoking Status |
Observation.status | Constrain status to - final, amended, corrected | |
QDM Attributes | ||
code | Observation.code | Fixed LOINC code 72166-2 |
id | Observation.id | |
method | Observation.method | |
relatedTo | Observation.basedOn | |
negation rationale | Observation.dataAbsentReason | |
reason | ||
result | Observation.valueCodeableConcept | |
Relevant dateTime | Observation.effective[x] | |
Relevant Period | Observation.effective[x] | |
Author dateTime | Observation.issued | Consider if authorDatetime (intended for negation rationale) fits with observation.issued or FHIR provenance for docuemtnation of the dataAbsentReason. |
Component | Observation.component | |
Observation.component.id | ||
Component code | Observation.component.code | |
Component result | Observation.component.value[x] | |
Observation.component.dataAbsentReason | ||
Performer | Observation.performer |
To address the QDM attribute Assessment, Order see Service Request
To address the QDM attribute Assessment, Recommended see Service Request