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

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

submissions to PQRI testing
--This line, and thoseA below, will be ignored--

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: 15.8 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"/>
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="01.01.01.100000001"/>
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>WEST VIRGINIA</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<templateId root="2.16.840.1.113883.3.249.11.3"/>
190<templateId root="2.16.840.1.113883.3.249.11.4"/>
191<templateId root="2.16.840.1.113883.3.249.11.5"/>
192<templateId root="2.16.840.1.113883.3.249.11.6"/>
193<templateId root="2.16.840.1.113883.3.249.11.7"/>
194<templateId root="2.16.840.1.113883.3.249.11.8"/>
195<templateId root="2.16.840.1.113883.3.249.11.9"/>
196<templateId root="2.16.840.1.113883.3.249.11.10"/>
197<templateId root="2.16.840.1.113883.3.249.11.11"/>
198<templateId root="2.16.840.1.113883.3.249.11.15"/>
199<templateId root="2.16.840.1.113883.3.249.11.51"/>
200<templateId root="2.16.840.1.113883.3.249.11.52"/>
201<templateId root="2.16.840.1.113883.3.249.11.53"/>
202<templateId root="2.16.840.1.113883.3.249.11.54"/>
203<templateId root="2.16.840.1.113883.3.249.11.55"/>
204<templateId root="2.16.840.1.113883.3.249.11.56"/>
205<templateId root="2.16.840.1.113883.3.249.11.57"/>
206<templateId root="2.16.840.1.113883.3.249.11.58"/>
207<templateId root="2.16.840.1.113883.3.249.11.59"/>
208<templateId root="2.16.840.1.113883.3.249.11.60"/>
209<code code="55186-1" codeSystem="2.16.840.1.113883.6.1"/>
210<title>Measure Section</title>
211<text>
212<list>
213<item>CMS Measure #1: Diabetes Mellitus: Hemoglobin A1c Poor Control in Diabetes Mellitus</item>
214<item>CMS Measure #2: Diabetes Mellitus: Low Density Lipoprotein (LDL-C) Control in Diabetes Mellitus</item>
215<item>CMS Measure #3: Diabetes Mellitus: High Blood Pressure Control in Diabetes Mellitus</item>
216<item>CMS Measure #5: Heart Failure: Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)</item>
217<item>CMS Measure #7: Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI)</item>
218<item>CMS Measure #110: Preventive Care and Screening: Influenza Immunization for Patients &gt;= 50 Years</item>
219<item>CMS Measure #111: Preventive Care and Screening: Pneumonia Vaccination for Patients 65 Years and Older</item>
220<item>CMS Measure #112: Preventive Care and Screening: Screening Mammography</item>
221<item>CMS Measure #113: Preventive Care and Screening: Colorectal Cancer Screening</item>
222<item>CMS Measure #124: Health Information Technology (HIT): Adoption/Use of Electronic Health Records (EHR)</item>
223<item>CMS Measure eRx:Adoption/Use of Medication Electronic Prescribing Measure</item>
224<item>CMS Measure #39: Screening or Therapy for Osteoporosis for Women Aged 65 Years and Older</item>
225<item>CMS Measure #47: Advance Care Plan </item>
226<item>CMS Measure #48: Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older</item>
227<item>CMS Measure #128: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up </item>
228<item>CMS Measure #173: Preventive Care and Screening: Unhealthy Alcohol Use - Screening</item>
229<item>CMS Measure #0013: Hypertension (HTN): Blood Pressure Measurement - QRDA Cat I template </item>
230<item>CMS Measure #0022: Drugs to be avoided in the Elderly </item>
231<item>CMS Measure #0024: Body Mass Index (BMI) 2 through 18 years of age </item>
232<item>CMS Measure #0028: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention</item>
233<item>CMS Measure #0038: Childhood Immunization Status - QRDA Cat I template</item>
234</list>
235</text>
236<entry typeCode="DRIV">
237<act classCode="ACT" moodCode="DEF">
238<code code="PQRI-1" codeSystem="2.16.840.1.113883.3.249.12" displayName="Hemoglobin A1c Poor Control in Diabetes Mellitus"/>
239<text>Percentage of patients 18 through 75 years with diabetes mellitus who had most recent hemoglobin A1C greater than 9.0%</text>
240<statusCode code="completed"/>
241</act>
242</entry>
243<component>
244<section>
245<code code="55187-9" codeSystem="2.16.840.1.113883.6.1"/>
246<title>Reporting Parameters</title>
247<text>
248<list>
249<item>Reporting Period Jan 1, 2010 to Dec 31, 2010</item>
250</list>
251</text>
252<entry>
253<act classCode="ACT" moodCode="EVN">
254<code code="252116004" codeSystem="2.16.840.1.113883.6.96" displayName="Observation Parameters"/>
255<effectiveTime>
256<low value="20100101"/>
257<high value="20101231"/>
258</effectiveTime>
259</act>
260</entry>
261</section>
262</component>
263<component>
264<section>
265<code code="55188-7" codeSystem="2.16.840.1.113883.6.1"/>
266<title>Patient Data</title>
267</section>
268</component>
269<component>
270<section>
271<templateId root="2.16.840.1.113883.3.88.11.83.103" assigningAuthorityName="HITSP/C83"/>
272<templateId root="1.3.6.1.4.1.19376.1.5.3.1.3.6" assigningAuthorityName="IHE PCC"/>
273<templateId root="2.16.840.1.113883.10.20.1.11" assigningAuthorityName="HL7 CCD"/>
274<code code="11450-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Problem list"/>
275<title>Problems</title>
276<text/>
277<entry typeCode="DRIV">
278<act classCode="ACT" moodCode="EVN">
279<templateId root="2.16.840.1.113883.10.20.1.27"/>
280<id root="PROBLEM1" extension="CCRObjectID"/>
281<code nullFlavor="NA"/>
282<performer typeCode="PRF">
283<assignedEntity>
284<id extension="ACTORPROVIDER_10000000020" root="CCRActorID"/>
285<addr use="WP">
286<streetAddressLine>VA MEDICAL CENTER</streetAddressLine>
287<city>ALBANY</city>
288<state>NY</state>
289<postalCode>12180</postalCode>
290</addr>
291<telecom/>
292<assignedPerson>
293<name>
294<given>NANCY</given>
295<family>ANTHRACITE</family>
296</name>
297</assignedPerson>
298</assignedEntity>
299</performer>
300<entryRelationship typeCode="SUBJ">
301<observation classCode="OBS" moodCode="EVN">
302<templateId root="2.16.840.1.113883.10.20.1.28" assigningAuthorityName="CCD"/>
303<id root="PROBLEM1" extension="CCRObjectID"/>
304<code code="55607006" displayName="Problem" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNM"/>
305<text>
306<reference value="#PROBLEM1"/>
307</text>
308<statusCode code="completed"/>
309<effectiveTime>
310<low value="20101013"/>
311<high value="20101013"/>
312</effectiveTime>
313<value xsi:type="CD" displayName="Diabetes Mellitus without mention of Complication, type II or unspecified type," code="250.02" codeSystemName="I9" codeSystem="2.16.840.1.113883.6.103"/>
314<entryRelationship typeCode="REFR">
315<observation classCode="OBS" moodCode="EVN">
316<templateId root="2.16.840.1.113883.10.20.1.50"/>
317<code code="33999-4" codeSystem="2.16.840.1.113883.6.1" displayName="Status"/>
318<statusCode code="completed"/>
319<value xsi:type="CD" code="55561003" codeSystem="2.16.840.1.113883.6.96" displayName="Active" codeSystemName="SNM">
320<originalText>Active</originalText>
321</value>
322</observation>
323</entryRelationship>
324</observation>
325</entryRelationship>
326</act>
327</entry>
328<entry typeCode="DRIV">
329<act classCode="ACT" moodCode="EVN">
330<templateId root="2.16.840.1.113883.10.20.1.27"/>
331<id root="PROBLEM2" extension="CCRObjectID"/>
332<code nullFlavor="NA"/>
333<performer typeCode="PRF">
334<assignedEntity>
335<id extension="ACTORPROVIDER_10000000183" root="CCRActorID"/>
336<addr use="WP">
337<streetAddressLine>VA MEDICAL CENTER</streetAddressLine>
338<city>ALBANY</city>
339<state>NY</state>
340<postalCode>12180</postalCode>
341</addr>
342<telecom/>
343<assignedPerson>
344<name>
345<given>MATTHEW</given>
346<given>M</given>
347<family>KING</family>
348</name>
349</assignedPerson>
350</assignedEntity>
351</performer>
352<entryRelationship typeCode="SUBJ">
353<observation classCode="OBS" moodCode="EVN">
354<templateId root="2.16.840.1.113883.10.20.1.28" assigningAuthorityName="CCD"/>
355<id root="PROBLEM2" extension="CCRObjectID"/>
356<code code="55607006" displayName="Problem" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNM"/>
357<text>
358<reference value="#PROBLEM2"/>
359</text>
360<statusCode code="completed"/>
361<effectiveTime>
362<low value="20100104"/>
363<high value="20100104"/>
364</effectiveTime>
365<value xsi:type="CD" displayName="Diabetes Mellitus" code="250.00" codeSystemName="I9" codeSystem="2.16.840.1.113883.6.103"/>
366<entryRelationship typeCode="REFR">
367<observation classCode="OBS" moodCode="EVN">
368<templateId root="2.16.840.1.113883.10.20.1.50"/>
369<code code="33999-4" codeSystem="2.16.840.1.113883.6.1" displayName="Status"/>
370<statusCode code="completed"/>
371<value xsi:type="CD" code="55561003" codeSystem="2.16.840.1.113883.6.96" displayName="Active" codeSystemName="SNM">
372<originalText>Active</originalText>
373</value>
374</observation>
375</entryRelationship>
376</observation>
377</entryRelationship>
378</act>
379</entry>
380</section>
381</component>
382<component>
383<section>
384<templateId root="2.16.840.1.113883.10.20.1.9"/>
385<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment Sources"/>
386<title>Payers</title>
387<entry typeCode="DRIV">
388<act classCode="ACT" moodCode="DEF">
389<templateId root="2.16.840.1.113883.10.20.1.20"/>
390<id root="1751b180-8a54-11df-a4ee-0800200c9c66"/>
391<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" displayName="Payment sources"/>
392<statusCode code="completed"/>
393<entryRelationship typeCode="COMP">
394<act classCode="ACT" moodCode="EVN">
395<templateId root="2.16.840.1.113883.10.20.1.26"/>
396<id root="dbbb6311-8a4d-11df-a4ee-0800200c9c66"/>
397<code code="PUBLICPOL" codeSystem="2.16.840.1.113883.5.4" displayName="Public Healthcare"/>
398<statusCode code="completed"/>
399<performer typeCode="PRF">
400<assignedEntity>
401<id root="2.16.840.1.113883.12.86" extension="MC"/>
402</assignedEntity>
403</performer>
404<participant typeCode="COV">
405<participantRole>
406<id root="2.16.840.1.113883.4.1" extension="666000200"/>
407<code code="SELF" codeSystem="2.16.840.1.113883.5.111" displayName="Self"/>
408</participantRole>
409</participant>
410</act>
411</entryRelationship>
412</act>
413</entry>
414</section>
415</component>
416</section>
417</component>
418</section>
419</component>
420</structuredBody>
421</component>
422</ClinicalDocument>
Note: See TracBrowser for help on using the repository browser.