source: qrda/CCR/PQRI-101026/M1-PAT_100146_QRDA_V1_0_0Ver2-gpl.xml@ 1338

Last change on this file since 1338 was 990, checked in by George Lilly, 14 years ago

submissions to PQRI testing
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A CCR/PQRI-101026
A CCR/PQRI-101026/M1-PAT_100146_QRDA_V1_0_0Ver2-gpl.xml
A CCR/PQRI-101026/M1-PAT_100146_QRDA_V1_0_0Ver2.xml
A CCR/PQRI-101026/M1-PAT_100850_QRDA_V1_0_0Ver2.xml
A CCR/PQRI-101026/M1-PAT_100852_QRDA_V1_0_0Ver2.xml
A CCR/PQRI-101026/M1-PAT_100846_QRDA_V1_0_0Ver2.xml
A CCR/PQRI-101026/M1-PAT_100855_QRDA_V1_0_0Ver2.xml
A CCR/PQRI-101026/M1-PAT_100847_QRDA_V1_0_0Ver2.xml
A CCR/PQRI-101026/cda.xsl
A CCR/PQRI-101026/M1-PAT_100839_QRDA_V1_0_0Ver2.xml
A CCR/PQRI-101026/M1-PAT_100848_QRDA_V1_0_0Ver2.xml
A CCR/PQRI-101026/M1-PAT_100858_QRDA_V1_0_0Ver2.xml
A CCR/PQRI-101026/M1-PAT_100849_QRDA_V1_0_0Ver2.xml
File size: 9.0 KB
Line 
1<?xml version="1.0" encoding="utf-8"?>
2<?xml-stylesheet type="text/xsl" href="cda.xsl"?>
3<ClinicalDocument xmlns="urn:hl7-org:v3" xmlns:voc="urn:hl7-org:v3/voc" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="urn:hl7-org:v3 CDA.xsd">
4<realmCode code="US"/>
5<typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040"/>
6<templateId root="2.16.840.1.113883.10.20.12"/>
7<templateId root="2.16.840.1.113883.3.249.11.100.1"/>
8<id root="e790ee1e-1dc0-491a-9e2c-870eea611db8" extension="01"/>
9<code code="55182-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Quality Measure Report"/>
10<title>QRDA Incidence Report</title>
11<effectiveTime value="20100703"/>
12<confidentialityCode codeSystem="2.16.840.1.113883.5.25" code="N"/>
13<languageCode code="en-US"/>
14<setId root="2.16.840.1.113883.3.543" extension="01"/>
15<versionNumber value="1"/>
16<recordTarget>
17<patientRole>
18<id extension="666000200" root="2.16.840.1.113883.4.1"/>
19<addr use="H">
20<streetAddressLine>Any Street</streetAddressLine>
21<city>Any Town</city>
22<state>WV</state>
23<postalCode/>
24</addr>
25<telecom use="" value="tel:+1-222-555-8235"/>
26<patient>
27<name>
28<given>MALE-D</given>
29<family>MEASURE-TWO</family>
30</name>
31<administrativeGenderCode displayName="MALE" code="M" codeSystemName="HL7 AdministrativeGender" codeSystem="2.16.840.1.113883.5.1"/>
32<birthTime value="1960111200"/>
33<raceCode code="2076-8" codeSystem="2.16.840.1.113883.5.104"/>
34<ethnicGroupCode code="2186-5" codeSystem="2.16.840.1.113883.5.50"/>
35</patient>
36 <providerOrganization>
37<!-- NPI for the provider-->
38 <id root="2.16.840.1.113883.4.6" extension="1558574525" />
39 <name>WorldVistA Test Clinic</name>
40 <!--WVV Address of organization is optional except for the STATE-->
41 <addr>
42 <state>MD</state>
43 <postalCode>20877</postalCode>
44
45 </addr>
46 <!--WVP required asOrganizationPartOf added to sample-->
47 <asOrganizationPartOf>
48 <wholeOrganization>
49 <!-- Tax ID is the extension-->
50 <id root="2.16.840.1.113883.4.2" extension="226864459"/>
51 </wholeOrganization>
52 </asOrganizationPartOf>
53 </providerOrganization>
54
55</patientRole>
56</recordTarget>
57<author>
58<time value="20100703"/>
59<assignedAuthor>
60<id root="2.16.840.1.113883.3.249.6" extension="100001"/>
61<assignedPerson>
62<name>
63<given>Nancy</given>
64<family>Anthracite</family>
65<suffix>MD</suffix>
66</name>
67</assignedPerson>
68<representedOrganization>
69<id root="2.16.840.1.113883.3.543" extension="1558574526"/>
70<name>WorldVistA Test Clinic</name>
71</representedOrganization>
72</assignedAuthor>
73</author>
74<informant>
75<assignedEntity>
76<id nullFlavor="NA"/>
77<representedOrganization>
78<id root="2.16.840.1.113883.3.543" extension="1558574526"/>
79<name>World VistA Test Clinic</name>
80</representedOrganization>
81</assignedEntity>
82</informant>
83<custodian>
84<assignedCustodian>
85<representedCustodianOrganization>
86<id root="2.16.840.1.113883.3.543" extension="1558574526"/>
87<name>WorldVistA Test Clinic</name>
88</representedCustodianOrganization>
89</assignedCustodian>
90</custodian>
91<legalAuthenticator>
92<time value="20100703"/>
93<signatureCode code="S"/>
94<assignedEntity>
95<id root="2.16.840.1.113883.3.543" extension="111111"/>
96<assignedPerson>
97<name>
98<given>Nancy</given>
99<family>Anthracite</family>
100<suffix>MD</suffix>
101</name>
102</assignedPerson>
103<representedOrganization>
104<id root="2.16.840.1.113883.3.543" extension="1558574526"/>
105<name>WorldVistA Test Clinic</name>
106</representedOrganization>
107</assignedEntity>
108</legalAuthenticator>
109<participant typeCode="PRF">
110<functionCode code="PCP" codeSystem="2.16.840.1.113883.5.88"/>
111<associatedEntity classCode="PROV">
112<id root="2.16.840.1.113883.3.249.6" extension="111111"/>
113<associatedPerson>
114<name>
115<prefix>Dr.</prefix>
116<given>Nancy</given>
117<family>Anthracite</family>
118</name>
119</associatedPerson>
120</associatedEntity>
121</participant>
122<documentationOf>
123<serviceEvent>
124<code displayName="Office/Outpatient Visit of an Established Patient requiring (2 of 3) an Expanded History, an Exam and Medical Decision Making of Low Complexity (CPT-4 99213)" code="99213" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
125<effectiveTime>
126<low value="20100104"/>
127<high value="20100104"/>
128</effectiveTime>
129<performer typeCode="PRF">
130 <assignedEntity>
131 <id root="2.16.840.1.113883.4.6" extension="1558574525"/>
132 <code code="62247001" codeSystem="2.16.840.1.113883.6.69" codeSystemName="SNM CT" displayName="Internal Medician Specialist"/>
133 <addr>
134 <streetAddressLine>123 Maple Ave</streetAddressLine>
135 <city>Gaithersburg</city>
136 <state>MD</state>
137 <postalCode>20877</postalCode>
138 </addr>
139 <assignedPerson>
140 <name>
141 <given>Nancy</given>
142 <family>Anthracite</family>
143 <suffix>MD</suffix>
144 </name>
145 </assignedPerson>
146 </assignedEntity>
147 </performer>
148 </serviceEvent>
149 </documentationOf>
150<documentationOf>
151<serviceEvent>
152<code displayName="INTERMEDIATE (30min)" code="99242" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
153<effectiveTime>
154<low value="20101014"/>
155<high value="20101014"/>
156</effectiveTime>
157<performer typeCode="PRF">
158 <assignedEntity>
159 <id root="2.16.840.1.113883.4.6" extension="1558574525"/>
160 <code code="62247001" codeSystem="2.16.840.1.113883.6.69" codeSystemName="SNM CT" displayName="Internal Medician Specialist"/>
161 <addr>
162 <streetAddressLine>123 Maple Ave</streetAddressLine>
163 <city>Gaithersburg</city>
164 <state>MD</state>
165 <postalCode>20877</postalCode>
166 </addr>
167 <assignedPerson>
168 <name>
169 <given>Nancy</given>
170 <family>Anthracite</family>
171 <suffix>MD</suffix>
172 </name>
173 </assignedPerson>
174 </assignedEntity>
175 </performer>
176 </serviceEvent>
177 </documentationOf>
178<component>
179<structuredBody>
180<component>
181<section>
182<templateId root="2.16.840.1.113883.3.249.11.50"/>
183<code code="55185-3" codeSystem="2.16.840.1.113883.6.1"/>
184<title>Measure set: CMS EHR Measure Set</title>
185<text>2010 Measures Set Measures</text>
186<component>
187<section>
188<templateId root="2.16.840.1.113883.3.249.11.2"/>
189<code code="55186-1" codeSystem="2.16.840.1.113883.6.1"/>
190<title>Measure Section</title>
191<text>
192<list>
193<item>CMS Measure #1: Diabetes Mellitus: Hemoglobin A1c Poor Control in Diabetes Mellitus</item>
194</list>
195</text>
196<entry typeCode="DRIV">
197<act classCode="ACT" moodCode="DEF">
198<id root="2.16.840.1.113883.3.249.11.2"/>
199<code code="PQRI-1" codeSystem="2.16.840.1.113883.3.249.12" displayName="Hemoglobin A1c Poor Control in Diabetes Mellitus"/>
200<text>Percentage of patients 18 through 75 years with diabetes mellitus who had most recent hemoglobin A1C greater than 9.0%</text>
201<statusCode code="completed"/>
202</act>
203</entry>
204<component>
205<section>
206<code code="55187-9" codeSystem="2.16.840.1.113883.6.1"/>
207<title>Reporting Parameters</title>
208<text>
209<list>
210<item>Reporting Period Jan 1, 2010 to Dec 31, 2010</item>
211</list>
212</text>
213<entry>
214<act classCode="ACT" moodCode="EVN">
215<code code="252116004" codeSystem="2.16.840.1.113883.6.96" displayName="Observation Parameters"/>
216<effectiveTime>
217<low value="20100101"/>
218<high value="20101231"/>
219</effectiveTime>
220</act>
221</entry>
222</section>
223</component>
224<component>
225<section>
226<code code="55188-7" codeSystem="2.16.840.1.113883.6.1"/>
227<title>Patient Data</title>
228</section>
229</component>
230<component>
231<section>
232<templateId root="2.16.840.1.113883.10.20.1.9"/>
233<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment Sources"/>
234<title>Payers</title>
235<text />
236<entry typeCode="DRIV">
237<act classCode="ACT" moodCode="DEF">
238<templateId root="2.16.840.1.113883.10.20.1.20"/>
239<id root="1751b180-8a54-11df-a4ee-0800200c9c66"/>
240<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" displayName="Payment sources"/>
241<statusCode code="completed"/>
242<entryRelationship typeCode="COMP">
243<act classCode="ACT" moodCode="EVN">
244<templateId root="2.16.840.1.113883.10.20.1.26"/>
245<templateId root="2.16.840.1.113883.3.249.11.100.7"/>
246<id root="dbbb6311-8a4d-11df-a4ee-0800200c9c66"/>
247<code code="PUBLICPOL" codeSystem="2.16.840.1.113883.5.4" displayName="Public Healthcare"/>
248<statusCode code="completed"/>
249<performer typeCode="PRF">
250<assignedEntity>
251<id root="2.16.840.1.113883.12.86" extension="MC"/>
252</assignedEntity>
253</performer>
254<participant typeCode="COV">
255<participantRole>
256<id root="2.16.840.1.113883.4.1" extension="666000200"/>
257<code code="SELF" codeSystem="2.16.840.1.113883.5.111" displayName="Self"/>
258</participantRole>
259</participant>
260</act>
261</entryRelationship>
262</act>
263</entry>
264</section>
265</component>
266</section>
267</component>
268</section>
269</component>
270</structuredBody>
271</component>
272</ClinicalDocument>
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