source: qrda/CCR/PQRI-101026/M1-PAT_100852_QRDA_V1_0_0Ver2.xml@ 1035

Last change on this file since 1035 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: 13.4 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="2cfcbbce-c1a9-4bbd-9189-b3e6b2e705c8"/>
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="453209394" 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>MALE-E</given>
28<family>MEASURE-ONE</family>
29</name>
30<administrativeGenderCode displayName="MALE" code="M" 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"/>
58<assignedAuthor>
59<id root="2.16.840.1.113883.3.249.6" extension="100001"/>
60<assignedPerson>
61<name>
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>
74<assignedEntity>
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="EXTENDED (30min)" code="99203" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
124<effectiveTime>
125<low value="20101013"/>
126<high value="20101013"/>
127</effectiveTime>
128<performer typeCode="PRF">
129 <assignedEntity>
130 <id root="2.16.840.1.113883.4.6" extension="1558574525"/>
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="LIMITED (10min)" code="99212" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
152<effectiveTime>
153<low value="20101014"/>
154<high value="20101014"/>
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>
179<component>
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"/>
190<templateId root="2.16.840.1.113883.3.249.11.5"/>
191<templateId root="2.16.840.1.113883.3.249.11.6"/>
192<templateId root="2.16.840.1.113883.3.249.11.7"/>
193<templateId root="2.16.840.1.113883.3.249.11.8"/>
194<templateId root="2.16.840.1.113883.3.249.11.9"/>
195<templateId root="2.16.840.1.113883.3.249.11.10"/>
196<templateId root="2.16.840.1.113883.3.249.11.11"/>
197<templateId root="2.16.840.1.113883.3.249.11.15"/>
198<templateId root="2.16.840.1.113883.3.249.11.51"/>
199<templateId root="2.16.840.1.113883.3.249.11.52"/>
200<templateId root="2.16.840.1.113883.3.249.11.53"/>
201<templateId root="2.16.840.1.113883.3.249.11.54"/>
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"/>
205<templateId root="2.16.840.1.113883.3.249.11.58"/>
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>
264<code code="55188-7" codeSystem="2.16.840.1.113883.6.1"/>
265<title>Patient Data</title>
266</section>
267</component>
268<component>
269<section>
270<templateId root="2.16.840.1.113883.3.88.11.83.103" assigningAuthorityName="HITSP/C83"/>
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="20101013"/>
310<high value="20101013"/>
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>
321</observation>
322</entryRelationship>
323</observation>
324</entryRelationship>
325</act>
326</entry>
327</section>
328</component>
329<component>
330<section>
331<templateId root="2.16.840.1.113883.10.20.1.9"/>
332<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment Sources"/>
333<title>Payers</title>
334<entry typeCode="DRIV">
335<act classCode="ACT" moodCode="DEF">
336<templateId root="2.16.840.1.113883.10.20.1.20"/>
337<id root="1751b180-8a54-11df-a4ee-0800200c9c66"/>
338<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" displayName="Payment sources"/>
339<statusCode code="completed"/>
340<entryRelationship typeCode="COMP">
341<act classCode="ACT" moodCode="EVN">
342<templateId root="2.16.840.1.113883.10.20.1.26"/>
343<id root="dbbb6311-8a4d-11df-a4ee-0800200c9c66"/>
344<code code="PUBLICPOL" codeSystem="2.16.840.1.113883.5.4" displayName="Public Healthcare"/>
345<statusCode code="completed"/>
346<performer typeCode="PRF">
347<assignedEntity>
348<id root="2.16.840.1.113883.12.86" extension="MC"/>
349</assignedEntity>
350</performer>
351<participant typeCode="COV">
352<participantRole>
353<id root="2.16.840.1.113883.4.1" extension="453209394"/>
354<code code="SELF" codeSystem="2.16.840.1.113883.5.111" displayName="Self"/>
355</participantRole>
356</participant>
357</act>
358</entryRelationship>
359</act>
360</entry>
361</section>
362</component>
363</section>
364</component>
365</section>
366</component>
367</structuredBody>
368</component>
369</ClinicalDocument>
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