Resolution:
Persusasive with mod
Create new profiles for notDone resources consistent with those QDM datatypes that use negation rationale in existing CMS program measures. The applicable QI-Core resources include: Observation, Procedure, ServiceRequest, Communication, Immunization, MedicationRequest, MedicationAdministration and MedicationDispensed.
Although not included in existing eCQMs, there is justification for using DeviceRequest especially for use cases such as appropriate orders for non-implantable devices such as Continuous Positive Airway Pressure (CPAP) machines for a diagnosis of obstructive sleep apnea. The use case is already addressed in existing DaVinci examples: Templates and Rules (which references a sleep study procedure and a CPAP DeviceRequest), LookupServiceInitiative _ _ (referencing documentation requirements for CPAP use), and PayerCoverageDecisionExchangeUseCases _ _ (referencing CPAP machines and face masks as devices). Therefore, QI-Core should retain Device _ _ and DeviceRequest _ _and QI-Core should develop a profile for DeviceNotRequested consistent with the other QDM negation rationale concepts.
Each profile to include the status, reason not done and timing.
1) create* timing extensions* for Communication.recorded, Procedure.recorded, MedicationAdministration.recorded, MedicationDispense.recorded
2) Create *extensions_ _ *for:
ServiceRequest.extension:reasonRefused
DeviceRequest.extension:reasonRefused
3) Profiles - Observation *(ObservationNotDone) - *
-
- notDoneReason = use a value set created from a combination of existing eCQM rationale value set (still extensible binding)
_** _timing = Observation.issued
4) Profile: Communication *(CommunicationNotDone) *
-
- statusReason = use a value set created from a combination of existing eCQM rationale value set (still extensible binding)
-
- timing = extension for Communication.recorded
5) Profile: Procedure *(ProcedureNotDone) *
-
- statusReason = use a value set created from a combination of existing eCQM rationale value set (still extensible binding)
-
- timing = new extension for Procedure.recorded
6) Profile: ServiceRequest *(ServiceNotRequested) *
-
- status = completed (I.e., no further action will be taken for this request)
-
- extension for ServiceRequest.extension:reasonRefused - use a value set created from a combination of existing eCQM rationale value set (still extensible binding)
-
- timing = ServiceRequest.authoredOn
7) Profile: Immunization (ImmunizationNotDone)
-
-
- statusReason* - use a _value set created from a combination of existing eCQM rationale value set (still extensible binding) _
-
- timing = Immunization.recorded
7) Profile MedicationRequest (MedicationNotRequested)
-
- MedicationRequest.reasonCode = use a value set created from a combination of existing eCQM rationale value set (still extensible binding)
-
- timing = MedicationRequest.authoredOn
8) Profile: MedicationAdministration (MedicationAdministrationNotDone)
-
- statusReason = use a value set created from a combination of existing eCQM rationale value set (still extensible binding)
-
- timing = extension for MedicationAdministration.recorded
9) Profile: MedicationDispensed ( MedicationDispensedNotDone:
-
- MedicationDispense.statusReason = use a value set created from a combination of existing eCQM rationale value set (still extensible binding)
-
- timing = extension for MedicationDispense.recorded
10) Profile DeviceRequest (DeviceNotRequested)
-
- DeviceRequest.reasonCode = use a value set created from a combination of existing eCQM rationale value set (still extensible binding)
-
- timing = DeviceRequest.authoredOn
The following specific profiles inherited in QI-Core should use ObservationNotDone when referencing reasons they were not performed and using the specific code in the inherited profile to reference what observation did not occur: (FHIR Vital Signs Profile, US Core Smoking Status Profile, US Core Laboratory Result Profile, US Core Pediatric Bmi For Age Profile, US Core Pediatric Weight For Height Profile, US Core Pulse Oximetry Profile).
Change Request
Medium
BALLOT-11110 Negative - Floyd Eisenberg : 2019-Sep-FHIR IG QICORE R1
