source: qrda/CCR/PQRI-101026/M1-PAT_100850_QRDA_V1_0_0Ver2.xml@ 1364

Last change on this file since 1364 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: 16.8 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="91a30f3a-7691-43fc-80c0-7c0282e1fac3"/>
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="098487630" 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-D</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>
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69<name>WorldVistA Test Clinic</name>
70</representedOrganization>
71</assignedAuthor>
72</author>
73<informant>
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76<representedOrganization>
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78<name>World VistA Test Clinic</name>
79</representedOrganization>
80</assignedEntity>
81</informant>
82<custodian>
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84<representedCustodianOrganization>
85<id root="2.16.840.1.113883.3.543" extension="1558574526"/>
86<name>WorldVistA Test Clinic</name>
87</representedCustodianOrganization>
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89</custodian>
90<legalAuthenticator>
91<time value="20100703"/>
92<signatureCode code="S"/>
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95<assignedPerson>
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97<given>Nancy</given>
98<family>Anthracite</family>
99<suffix>MD</suffix>
100</name>
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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">
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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 (20min)" code="99202" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
124<effectiveTime>
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126<high value="20101014"/>
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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<documentationOf>
150<serviceEvent>
151<code displayName="INTERMEDIATE (20min)" code="99202" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
152<effectiveTime>
153<low value="20101013"/>
154<high value="20101013"/>
155</effectiveTime>
156<performer typeCode="PRF">
157 <assignedEntity>
158 <id root="2.16.840.1.113883.4.6" extension="1558574525"/>
159 <code code="62247001" codeSystem="2.16.840.1.113883.6.69" codeSystemName="SNM CT" displayName="Internal Medician Specialist"/>
160 <addr>
161 <streetAddressLine>123 Maple Ave</streetAddressLine>
162 <city>Gaithersburg</city>
163 <state>MD</state>
164 <postalCode>20877</postalCode>
165 </addr>
166 <assignedPerson>
167 <name>
168 <given>Nancy</given>
169 <family>Anthracite</family>
170 <suffix>MD</suffix>
171 </name>
172 </assignedPerson>
173 </assignedEntity>
174 </performer>
175 </serviceEvent>
176 </documentationOf>
177<component>
178<structuredBody>
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180<section>
181<templateId root="2.16.840.1.113883.3.249.11.50"/>
182<code code="55185-3" codeSystem="2.16.840.1.113883.6.1"/>
183<title>Measure set: CMS EHR Measure Set</title>
184<text>2010 Measures Set Measures</text>
185<component>
186<section>
187<templateId root="2.16.840.1.113883.3.249.11.2"/>
188<templateId root="2.16.840.1.113883.3.249.11.3"/>
189<templateId root="2.16.840.1.113883.3.249.11.4"/>
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191<templateId root="2.16.840.1.113883.3.249.11.6"/>
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202<templateId root="2.16.840.1.113883.3.249.11.55"/>
203<templateId root="2.16.840.1.113883.3.249.11.56"/>
204<templateId root="2.16.840.1.113883.3.249.11.57"/>
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206<templateId root="2.16.840.1.113883.3.249.11.59"/>
207<templateId root="2.16.840.1.113883.3.249.11.60"/>
208<code code="55186-1" codeSystem="2.16.840.1.113883.6.1"/>
209<title>Measure Section</title>
210<text>
211<list>
212<item>CMS Measure #1: Diabetes Mellitus: Hemoglobin A1c Poor Control in Diabetes Mellitus</item>
213<item>CMS Measure #2: Diabetes Mellitus: Low Density Lipoprotein (LDL-C) Control in Diabetes Mellitus</item>
214<item>CMS Measure #3: Diabetes Mellitus: High Blood Pressure Control in Diabetes Mellitus</item>
215<item>CMS Measure #5: Heart Failure: Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)</item>
216<item>CMS Measure #7: Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI)</item>
217<item>CMS Measure #110: Preventive Care and Screening: Influenza Immunization for Patients &gt;= 50 Years</item>
218<item>CMS Measure #111: Preventive Care and Screening: Pneumonia Vaccination for Patients 65 Years and Older</item>
219<item>CMS Measure #112: Preventive Care and Screening: Screening Mammography</item>
220<item>CMS Measure #113: Preventive Care and Screening: Colorectal Cancer Screening</item>
221<item>CMS Measure #124: Health Information Technology (HIT): Adoption/Use of Electronic Health Records (EHR)</item>
222<item>CMS Measure eRx:Adoption/Use of Medication Electronic Prescribing Measure</item>
223<item>CMS Measure #39: Screening or Therapy for Osteoporosis for Women Aged 65 Years and Older</item>
224<item>CMS Measure #47: Advance Care Plan </item>
225<item>CMS Measure #48: Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older</item>
226<item>CMS Measure #128: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up </item>
227<item>CMS Measure #173: Preventive Care and Screening: Unhealthy Alcohol Use - Screening</item>
228<item>CMS Measure #0013: Hypertension (HTN): Blood Pressure Measurement - QRDA Cat I template </item>
229<item>CMS Measure #0022: Drugs to be avoided in the Elderly </item>
230<item>CMS Measure #0024: Body Mass Index (BMI) 2 through 18 years of age </item>
231<item>CMS Measure #0028: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention</item>
232<item>CMS Measure #0038: Childhood Immunization Status - QRDA Cat I template</item>
233</list>
234</text>
235<entry typeCode="DRIV">
236<act classCode="ACT" moodCode="DEF">
237<code code="PQRI-1" codeSystem="2.16.840.1.113883.3.249.12" displayName="Hemoglobin A1c Poor Control in Diabetes Mellitus"/>
238<text>Percentage of patients 18 through 75 years with diabetes mellitus who had most recent hemoglobin A1C greater than 9.0%</text>
239<statusCode code="completed"/>
240</act>
241</entry>
242<component>
243<section>
244<code code="55187-9" codeSystem="2.16.840.1.113883.6.1"/>
245<title>Reporting Parameters</title>
246<text>
247<list>
248<item>Reporting Period Jan 1, 2010 to Dec 31, 2010</item>
249</list>
250</text>
251<entry>
252<act classCode="ACT" moodCode="EVN">
253<code code="252116004" codeSystem="2.16.840.1.113883.6.96" displayName="Observation Parameters"/>
254<effectiveTime>
255<low value="20100101"/>
256<high value="20101231"/>
257</effectiveTime>
258</act>
259</entry>
260</section>
261</component>
262<component>
263<section>
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265<title>Patient Data</title>
266</section>
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268<component>
269<section>
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271<templateId root="1.3.6.1.4.1.19376.1.5.3.1.3.6" assigningAuthorityName="IHE PCC"/>
272<templateId root="2.16.840.1.113883.10.20.1.11" assigningAuthorityName="HL7 CCD"/>
273<code code="11450-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Problem list"/>
274<title>Problems</title>
275<text/>
276<entry typeCode="DRIV">
277<act classCode="ACT" moodCode="EVN">
278<templateId root="2.16.840.1.113883.10.20.1.27"/>
279<id root="PROBLEM1" extension="CCRObjectID"/>
280<code nullFlavor="NA"/>
281<performer typeCode="PRF">
282<assignedEntity>
283<id extension="ACTORPROVIDER_10000000020" root="CCRActorID"/>
284<addr use="WP">
285<streetAddressLine>VA MEDICAL CENTER</streetAddressLine>
286<city>ALBANY</city>
287<state>NY</state>
288<postalCode>12180</postalCode>
289</addr>
290<telecom/>
291<assignedPerson>
292<name>
293<given>NANCY</given>
294<family>ANTHRACITE</family>
295</name>
296</assignedPerson>
297</assignedEntity>
298</performer>
299<entryRelationship typeCode="SUBJ">
300<observation classCode="OBS" moodCode="EVN">
301<templateId root="2.16.840.1.113883.10.20.1.28" assigningAuthorityName="CCD"/>
302<id root="PROBLEM1" extension="CCRObjectID"/>
303<code code="55607006" displayName="Problem" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNM"/>
304<text>
305<reference value="#PROBLEM1"/>
306</text>
307<statusCode code="completed"/>
308<effectiveTime>
309<low value="20101014"/>
310<high value="20101014"/>
311</effectiveTime>
312<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"/>
313<entryRelationship typeCode="REFR">
314<observation classCode="OBS" moodCode="EVN">
315<templateId root="2.16.840.1.113883.10.20.1.50"/>
316<code code="33999-4" codeSystem="2.16.840.1.113883.6.1" displayName="Status"/>
317<statusCode code="completed"/>
318<value xsi:type="CD" code="55561003" codeSystem="2.16.840.1.113883.6.96" displayName="Active" codeSystemName="SNM">
319<originalText>Active</originalText>
320</value>
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322</entryRelationship>
323</observation>
324</entryRelationship>
325</act>
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327<entry typeCode="DRIV">
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331<code nullFlavor="NA"/>
332<performer typeCode="PRF">
333<assignedEntity>
334<id extension="ACTORPROVIDER_10000000020" root="CCRActorID"/>
335<addr use="WP">
336<streetAddressLine>VA MEDICAL CENTER</streetAddressLine>
337<city>ALBANY</city>
338<state>NY</state>
339<postalCode>12180</postalCode>
340</addr>
341<telecom/>
342<assignedPerson>
343<name>
344<given>NANCY</given>
345<family>ANTHRACITE</family>
346</name>
347</assignedPerson>
348</assignedEntity>
349</performer>
350<entryRelationship typeCode="SUBJ">
351<observation classCode="OBS" moodCode="EVN">
352<templateId root="2.16.840.1.113883.10.20.1.28" assigningAuthorityName="CCD"/>
353<id root="PROBLEM2" extension="CCRObjectID"/>
354<code code="55607006" displayName="Problem" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNM"/>
355<text>
356<reference value="#PROBLEM2"/>
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358<statusCode code="completed"/>
359<effectiveTime>
360<low value="20101014"/>
361<high value="20101014"/>
362</effectiveTime>
363<value xsi:type="CD" displayName="Diabetes (ICD-9-CM 250.00)" code="250.00" codeSystemName="I9" codeSystem="2.16.840.1.113883.6.103"/>
364<entryRelationship typeCode="REFR">
365<observation classCode="OBS" moodCode="EVN">
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369<value xsi:type="CD" code="55561003" codeSystem="2.16.840.1.113883.6.96" displayName="Active" codeSystemName="SNM">
370<originalText>Active</originalText>
371</value>
372</observation>
373</entryRelationship>
374</observation>
375</entryRelationship>
376</act>
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380<templateId root="2.16.840.1.113883.10.20.1.27"/>
381<id root="PROBLEM3" extension="CCRObjectID"/>
382<code nullFlavor="NA"/>
383<performer typeCode="PRF">
384<assignedEntity>
385<id extension="ACTORPROVIDER_10000000020" root="CCRActorID"/>
386<addr use="WP">
387<streetAddressLine>VA MEDICAL CENTER</streetAddressLine>
388<city>ALBANY</city>
389<state>NY</state>
390<postalCode>12180</postalCode>
391</addr>
392<telecom/>
393<assignedPerson>
394<name>
395<given>NANCY</given>
396<family>ANTHRACITE</family>
397</name>
398</assignedPerson>
399</assignedEntity>
400</performer>
401<entryRelationship typeCode="SUBJ">
402<observation classCode="OBS" moodCode="EVN">
403<templateId root="2.16.840.1.113883.10.20.1.28" assigningAuthorityName="CCD"/>
404<id root="PROBLEM3" extension="CCRObjectID"/>
405<code code="55607006" displayName="Problem" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNM"/>
406<text>
407<reference value="#PROBLEM3"/>
408</text>
409<statusCode code="completed"/>
410<effectiveTime>
411<low value="20101013"/>
412<high value="20101013"/>
413</effectiveTime>
414<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"/>
415<entryRelationship typeCode="REFR">
416<observation classCode="OBS" moodCode="EVN">
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418<code code="33999-4" codeSystem="2.16.840.1.113883.6.1" displayName="Status"/>
419<statusCode code="completed"/>
420<value xsi:type="CD" code="55561003" codeSystem="2.16.840.1.113883.6.96" displayName="Active" codeSystemName="SNM">
421<originalText>Active</originalText>
422</value>
423</observation>
424</entryRelationship>
425</observation>
426</entryRelationship>
427</act>
428</entry>
429</section>
430</component>
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434<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment Sources"/>
435<title>Payers</title>
436<entry typeCode="DRIV">
437<act classCode="ACT" moodCode="DEF">
438<templateId root="2.16.840.1.113883.10.20.1.20"/>
439<id root="1751b180-8a54-11df-a4ee-0800200c9c66"/>
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441<statusCode code="completed"/>
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446<code code="PUBLICPOL" codeSystem="2.16.840.1.113883.5.4" displayName="Public Healthcare"/>
447<statusCode code="completed"/>
448<performer typeCode="PRF">
449<assignedEntity>
450<id root="2.16.840.1.113883.12.86" extension="MC"/>
451</assignedEntity>
452</performer>
453<participant typeCode="COV">
454<participantRole>
455<id root="2.16.840.1.113883.4.1" extension="098487630"/>
456<code code="SELF" codeSystem="2.16.840.1.113883.5.111" displayName="Self"/>
457</participantRole>
458</participant>
459</act>
460</entryRelationship>
461</act>
462</entry>
463</section>
464</component>
465</section>
466</component>
467</section>
468</component>
469</structuredBody>
470</component>
471</ClinicalDocument>
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