source: qrda/CCR/PQRI-101026/M1-PAT_100848_QRDA_V1_0_0Ver2.xml@ 1252

Last change on this file since 1252 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: 14.2 KB
Line 
1<?xml version="1.0" encoding="utf-8"?>
2<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">
3<realmCode code="US"/>
4<typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040"/>
5<templateId root="2.16.840.1.113883.10.20.12"/>
6<templateId root="2.16.840.1.113883.3.249.11.100.1"/>
7<id root="22b05c64-c194-4feb-a0f4-0bcdebac6d00"/>
8<code code="55182-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Quality Measure Report"/>
9<title>QRDA Incidence Report</title>
10<effectiveTime value="20100703"/>
11<confidentialityCode codeSystem="2.16.840.1.113883.5.25" code="N"/>
12<languageCode code="en-US"/>
13<setId root="2.16.840.1.113883.3.543" extension="01.01.01.100000001"/>
14<versionNumber value="1"/>
15<recordTarget>
16<patientRole>
17<id extension="345097898" root="2.16.840.1.113883.4.1"/>
18<addr use="H">
19<streetAddressLine/>
20<city/>
21<state/>
22<postalCode/>
23</addr>
24<telecom/>
25<patient>
26<name>
27<given>FEMALE-B</given>
28<family>MEASURE-ONE</family>
29</name>
30<administrativeGenderCode displayName="FEMALE" code="F" codeSystemName="HL7 AdministrativeGender" codeSystem="2.16.840.1.113883.5.1"/>
31<birthTime value="1960111200"/>
32<raceCode code="2076-8" codeSystem="2.16.840.1.113883.5.104"/>
33<ethnicGroupCode code="2186-5" codeSystem="2.16.840.1.113883.5.50"/>
34</patient>
35 <providerOrganization>
36<!-- NPI for the provider-->
37 <id root="2.16.840.1.113883.4.6" extension="1558574525" />
38 <name>WorldVistA Test Clinic</name>
39 <!--WVV Address of organization is optional except for the STATE-->
40 <addr>
41 <state>MD</state>
42 <postalCode>20877</postalCode>
43
44 </addr>
45 <!--WVP required asOrganizationPartOf added to sample-->
46 <asOrganizationPartOf>
47 <wholeOrganization>
48 <!-- Tax ID is the extension-->
49 <id root="2.16.840.1.113883.4.2" extension="226864459"/>
50 </wholeOrganization>
51 </asOrganizationPartOf>
52 </providerOrganization>
53
54</patientRole>
55</recordTarget>
56<author>
57<time value="20100703"/>
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62<given>Nancy</given>
63<family>Anthracite</family>
64<suffix>MD</suffix>
65</name>
66</assignedPerson>
67<representedOrganization>
68<id root="2.16.840.1.113883.3.543" extension="1558574526"/>
69<name>WorldVistA Test Clinic</name>
70</representedOrganization>
71</assignedAuthor>
72</author>
73<informant>
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75<id nullFlavor="NA"/>
76<representedOrganization>
77<id root="2.16.840.1.113883.3.543" extension="1558574526"/>
78<name>World VistA Test Clinic</name>
79</representedOrganization>
80</assignedEntity>
81</informant>
82<custodian>
83<assignedCustodian>
84<representedCustodianOrganization>
85<id root="2.16.840.1.113883.3.543" extension="1558574526"/>
86<name>WorldVistA Test Clinic</name>
87</representedCustodianOrganization>
88</assignedCustodian>
89</custodian>
90<legalAuthenticator>
91<time value="20100703"/>
92<signatureCode code="S"/>
93<assignedEntity>
94<id root="2.16.840.1.113883.3.543" extension="111111"/>
95<assignedPerson>
96<name>
97<given>Nancy</given>
98<family>Anthracite</family>
99<suffix>MD</suffix>
100</name>
101</assignedPerson>
102<representedOrganization>
103<id root="2.16.840.1.113883.3.543" extension="1558574526"/>
104<name>WorldVistA Test Clinic</name>
105</representedOrganization>
106</assignedEntity>
107</legalAuthenticator>
108<participant typeCode="PRF">
109<functionCode code="PCP" codeSystem="2.16.840.1.113883.5.88"/>
110<associatedEntity classCode="PROV">
111<id root="2.16.840.1.113883.3.249.6" extension="111111"/>
112<associatedPerson>
113<name>
114<prefix>Dr.</prefix>
115<given>Nancy</given>
116<family>Anthracite</family>
117</name>
118</associatedPerson>
119</associatedEntity>
120</participant>
121<documentationOf>
122<serviceEvent>
123<code displayName="INTERMEDIATE (15min)" code="99213" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
124<effectiveTime>
125<low value="20100105"/>
126<high value="20100105"/>
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128<performer typeCode="PRF">
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131 <code code="62247001" codeSystem="2.16.840.1.113883.6.69" codeSystemName="SNM CT" displayName="Internal Medician Specialist"/>
132 <addr>
133 <streetAddressLine>123 Maple Ave</streetAddressLine>
134 <city>Gaithersburg</city>
135 <state>MD</state>
136 <postalCode>20877</postalCode>
137 </addr>
138 <assignedPerson>
139 <name>
140 <given>Nancy</given>
141 <family>Anthracite</family>
142 <suffix>MD</suffix>
143 </name>
144 </assignedPerson>
145 </assignedEntity>
146 </performer>
147 </serviceEvent>
148 </documentationOf>
149<component>
150<structuredBody>
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153<templateId root="2.16.840.1.113883.3.249.11.50"/>
154<code code="55185-3" codeSystem="2.16.840.1.113883.6.1"/>
155<title>Measure set: CMS EHR Measure Set</title>
156<text>2010 Measures Set Measures</text>
157<component>
158<section>
159<templateId root="2.16.840.1.113883.3.249.11.2"/>
160<templateId root="2.16.840.1.113883.3.249.11.3"/>
161<templateId root="2.16.840.1.113883.3.249.11.4"/>
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164<templateId root="2.16.840.1.113883.3.249.11.7"/>
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167<templateId root="2.16.840.1.113883.3.249.11.10"/>
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178<templateId root="2.16.840.1.113883.3.249.11.59"/>
179<templateId root="2.16.840.1.113883.3.249.11.60"/>
180<code code="55186-1" codeSystem="2.16.840.1.113883.6.1"/>
181<title>Measure Section</title>
182<text>
183<list>
184<item>CMS Measure #1: Diabetes Mellitus: Hemoglobin A1c Poor Control in Diabetes Mellitus</item>
185<item>CMS Measure #2: Diabetes Mellitus: Low Density Lipoprotein (LDL-C) Control in Diabetes Mellitus</item>
186<item>CMS Measure #3: Diabetes Mellitus: High Blood Pressure Control in Diabetes Mellitus</item>
187<item>CMS Measure #5: Heart Failure: Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)</item>
188<item>CMS Measure #7: Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI)</item>
189<item>CMS Measure #110: Preventive Care and Screening: Influenza Immunization for Patients &gt;= 50 Years</item>
190<item>CMS Measure #111: Preventive Care and Screening: Pneumonia Vaccination for Patients 65 Years and Older</item>
191<item>CMS Measure #112: Preventive Care and Screening: Screening Mammography</item>
192<item>CMS Measure #113: Preventive Care and Screening: Colorectal Cancer Screening</item>
193<item>CMS Measure #124: Health Information Technology (HIT): Adoption/Use of Electronic Health Records (EHR)</item>
194<item>CMS Measure eRx:Adoption/Use of Medication Electronic Prescribing Measure</item>
195<item>CMS Measure #39: Screening or Therapy for Osteoporosis for Women Aged 65 Years and Older</item>
196<item>CMS Measure #47: Advance Care Plan </item>
197<item>CMS Measure #48: Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older</item>
198<item>CMS Measure #128: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up </item>
199<item>CMS Measure #173: Preventive Care and Screening: Unhealthy Alcohol Use - Screening</item>
200<item>CMS Measure #0013: Hypertension (HTN): Blood Pressure Measurement - QRDA Cat I template </item>
201<item>CMS Measure #0022: Drugs to be avoided in the Elderly </item>
202<item>CMS Measure #0024: Body Mass Index (BMI) 2 through 18 years of age </item>
203<item>CMS Measure #0028: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention</item>
204<item>CMS Measure #0038: Childhood Immunization Status - QRDA Cat I template</item>
205</list>
206</text>
207<entry typeCode="DRIV">
208<act classCode="ACT" moodCode="DEF">
209<code code="PQRI-1" codeSystem="2.16.840.1.113883.3.249.12" displayName="Hemoglobin A1c Poor Control in Diabetes Mellitus"/>
210<text>Percentage of patients 18 through 75 years with diabetes mellitus who had most recent hemoglobin A1C greater than 9.0%</text>
211<statusCode code="completed"/>
212</act>
213</entry>
214<component>
215<section>
216<code code="55187-9" codeSystem="2.16.840.1.113883.6.1"/>
217<title>Reporting Parameters</title>
218<text>
219<list>
220<item>Reporting Period Jan 1, 2010 to Dec 31, 2010</item>
221</list>
222</text>
223<entry>
224<act classCode="ACT" moodCode="EVN">
225<code code="252116004" codeSystem="2.16.840.1.113883.6.96" displayName="Observation Parameters"/>
226<effectiveTime>
227<low value="20100101"/>
228<high value="20101231"/>
229</effectiveTime>
230</act>
231</entry>
232</section>
233</component>
234<component>
235<section>
236<code code="55188-7" codeSystem="2.16.840.1.113883.6.1"/>
237<title>Patient Data</title>
238</section>
239</component>
240<component>
241<section>
242<templateId root="2.16.840.1.113883.3.88.11.83.103" assigningAuthorityName="HITSP/C83"/>
243<templateId root="1.3.6.1.4.1.19376.1.5.3.1.3.6" assigningAuthorityName="IHE PCC"/>
244<templateId root="2.16.840.1.113883.10.20.1.11" assigningAuthorityName="HL7 CCD"/>
245<code code="11450-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Problem list"/>
246<title>Problems</title>
247<text/>
248<entry typeCode="DRIV">
249<act classCode="ACT" moodCode="EVN">
250<templateId root="2.16.840.1.113883.10.20.1.27"/>
251<id root="PROBLEM1" extension="CCRObjectID"/>
252<code nullFlavor="NA"/>
253<performer typeCode="PRF">
254<assignedEntity>
255<id extension="ACTORPROVIDER_991" root="CCRActorID"/>
256<addr use="WP">
257<streetAddressLine>VA MEDICAL CENTER</streetAddressLine>
258<city>ALBANY</city>
259<state>NY</state>
260<postalCode>12180</postalCode>
261</addr>
262<telecom/>
263<assignedPerson>
264<name>
265<prefix>Scholar Extraordinaire</prefix>
266<given>EIGHT</given>
267<family>PROVIDER</family>
268</name>
269</assignedPerson>
270</assignedEntity>
271</performer>
272<entryRelationship typeCode="SUBJ">
273<observation classCode="OBS" moodCode="EVN">
274<templateId root="2.16.840.1.113883.10.20.1.28" assigningAuthorityName="CCD"/>
275<id root="PROBLEM1" extension="CCRObjectID"/>
276<code code="55607006" displayName="Problem" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNM"/>
277<text>
278<reference value="#PROBLEM1"/>
279</text>
280<statusCode code="completed"/>
281<effectiveTime>
282<low value="20101013"/>
283<high value="20101013"/>
284</effectiveTime>
285<value xsi:type="CD" displayName="Diabetes Mellitus without mention of Complication, type II or unspecified type," code="250.00" codeSystemName="I9" codeSystem="2.16.840.1.113883.6.103"/>
286<entryRelationship typeCode="REFR">
287<observation classCode="OBS" moodCode="EVN">
288<templateId root="2.16.840.1.113883.10.20.1.50"/>
289<code code="33999-4" codeSystem="2.16.840.1.113883.6.1" displayName="Status"/>
290<statusCode code="completed"/>
291<value xsi:type="CD" code="55561003" codeSystem="2.16.840.1.113883.6.96" displayName="Active" codeSystemName="SNM">
292<originalText>Active</originalText>
293</value>
294</observation>
295</entryRelationship>
296</observation>
297</entryRelationship>
298</act>
299</entry>
300<entry typeCode="DRIV">
301<act classCode="ACT" moodCode="EVN">
302<templateId root="2.16.840.1.113883.10.20.1.27"/>
303<id root="PROBLEM2" extension="CCRObjectID"/>
304<code nullFlavor="NA"/>
305<performer typeCode="PRF">
306<assignedEntity>
307<id extension="ACTORPROVIDER_10000000183" root="CCRActorID"/>
308<addr use="WP">
309<streetAddressLine>VA MEDICAL CENTER</streetAddressLine>
310<city>ALBANY</city>
311<state>NY</state>
312<postalCode>12180</postalCode>
313</addr>
314<telecom/>
315<assignedPerson>
316<name>
317<given>MATTHEW</given>
318<given>M</given>
319<family>KING</family>
320</name>
321</assignedPerson>
322</assignedEntity>
323</performer>
324<entryRelationship typeCode="SUBJ">
325<observation classCode="OBS" moodCode="EVN">
326<templateId root="2.16.840.1.113883.10.20.1.28" assigningAuthorityName="CCD"/>
327<id root="PROBLEM2" extension="CCRObjectID"/>
328<code code="55607006" displayName="Problem" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNM"/>
329<text>
330<reference value="#PROBLEM2"/>
331</text>
332<statusCode code="completed"/>
333<effectiveTime>
334<low value="20100105"/>
335<high value="20100105"/>
336</effectiveTime>
337<value xsi:type="CD" displayName="Sprains (ICD-9-CM 848.9)" code="848.9" codeSystemName="I9" codeSystem="2.16.840.1.113883.6.103"/>
338<entryRelationship typeCode="REFR">
339<observation classCode="OBS" moodCode="EVN">
340<templateId root="2.16.840.1.113883.10.20.1.50"/>
341<code code="33999-4" codeSystem="2.16.840.1.113883.6.1" displayName="Status"/>
342<statusCode code="completed"/>
343<value xsi:type="CD" code="55561003" codeSystem="2.16.840.1.113883.6.96" displayName="Active" codeSystemName="SNM">
344<originalText>Active</originalText>
345</value>
346</observation>
347</entryRelationship>
348</observation>
349</entryRelationship>
350</act>
351</entry>
352</section>
353</component>
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357<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment Sources"/>
358<title>Payers</title>
359<entry typeCode="DRIV">
360<act classCode="ACT" moodCode="DEF">
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362<id root="1751b180-8a54-11df-a4ee-0800200c9c66"/>
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364<statusCode code="completed"/>
365<entryRelationship typeCode="COMP">
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369<code code="PUBLICPOL" codeSystem="2.16.840.1.113883.5.4" displayName="Public Healthcare"/>
370<statusCode code="completed"/>
371<performer typeCode="PRF">
372<assignedEntity>
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374</assignedEntity>
375</performer>
376<participant typeCode="COV">
377<participantRole>
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379<code code="SELF" codeSystem="2.16.840.1.113883.5.111" displayName="Self"/>
380</participantRole>
381</participant>
382</act>
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384</act>
385</entry>
386</section>
387</component>
388</section>
389</component>
390</section>
391</component>
392</structuredBody>
393</component>
394</ClinicalDocument>
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