source: qrda/schematron/QRDA_CategoryI_WorldVistAH-2011-Working.xml@ 1684

Last change on this file since 1684 was 929, checked in by George Lilly, 14 years ago

midnight update
File size: 81.3 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
5<!--
6********************************************************
7CDA Header
8********************************************************
9-->
10
11<!--
12******************
13Document Information
14**********************
15-->
16 <realmCode code="US" />
17 <typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040" />
18 <!--QRDA Category I generic template ID. -->
19 <templateId root="2.16.840.1.113883.10.20.12" />
20
21 <id root="88414c01-715a-45bb-83bb-db7ac860fe9d" />
22 <!-- PQRI QRDA Template ID -->
23 <templateId root="2.16.840.1.113883.3.249.11.100.1" />
24 <!--WVV 2.16.840.1.113883.3.543 is fixed and is the beginninng of WorldVistAs OID, change the extension for a new document and the version for changes to this one-->
25 <!-- WV? for this group of 10 documents we are submitting-->
26 <id root="2.16.840.1.113883.3.543" extension="01.01.01.122207000.1"/>
27 <!-- QRDA document type code (yet to be created). -->
28 <code code="55182-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Quality Measure Report" />
29 <title>QRDA Incidence Report</title>
30 <effectiveTime value="20100701" />
31 <confidentialityCode codeSystem="2.16.840.1.113883.5.25" code="N" />
32 <!-- setId is not fixed by PQRI - probably from an OID with the extension unique-->
33 <setId root="2.16.840.1.113883.3.543" extension="01.01.01.122700971"/>
34 <!-- versionNumber is not fixed by PQRI except must be an integer - probably sequential integer as this document is changed -->
35 <versionNumber value="1"/>
36 <languageCode code="en-US" />
37 <!-- This is the patient for which the report is describing. -->
38 <!--
39 *******************
40 Patient Information
41 ****************
42 -->
43 <recordTarget>
44 <patientRole>
45 <!--WVV Id coding system is in the downloadable resoure and SSN is the extension. Edit the extension here-->
46 <!--Can't change during the reporting period-->
47 <id root="2.16.840.1.113883.4.1" extension="0023167537"/>
48
49 <patient>
50 <name>
51 <!-- WV Edit -->
52 <given>Landy</given>
53 <family>Ford</family>
54 </name >
55 <!--WV address is not require and is not in the specifications at all -->
56 <addr>
57 <streetAddressLine>45 Easter Ave.</streetAddressLine>
58 <city>Rockville</city>
59 <state>MD</state>
60 <postalCode>20850</postalCode>
61 </addr>
62 <!--WV 2186-5 is Not Hispanic or Latino -->
63 <ethnicGroupCode code="2186-5" codeSystem="2.16.840.1.113883.5.50"/>
64 <!--VV Gender code can be M, F or UN for undifferentiated-->
65 <administrativeGenderCode code="F" codeSystem="2.16.840.1.113883.5.1"/>
66 <!--in downloadable resources 2054-5 is Back or African American -->
67 <!--WVV 2106-3 is white and there are no hispanic and a huge number of indian tribes-->
68 <raceCode code="2054-5" codeSystem="2.16.840.1.113883.5.104"/>
69 <!--WVV Birth Time at least to the day-->
70 <birthTime value="19430518"/>
71 </patient>
72 <!--WV Added to sample document and required NPI as extension and root is permanent Infomation about the NPI in the submission specs is wrong-->
73 <providerOrganization>
74 <!--This is the providers NPI number that can be validated with a checksum check algorithm-->
75 <!-- the 2.16.840.1.113883.4.6 is fixed and the extension the NPI number-->
76 <id root="2.16.840.1.113883.4.6" extension="1558574525" />
77 <name>WorldVistA Test Clinic</name>
78 <!--WVV address of organization which must have NPI is optional-->
79 <addr>
80 <streetAddressLine>123 Maple Ave</streetAddressLine>
81 <city>Gaithersburg</city>
82 <state>MD</state>
83 <postalCode>20877</postalCode>
84 </addr>
85 <!--WVP required asOrganizationPartOf added to sample-->
86 <asOrganizationPartOf>
87 <wholeOrganization>
88 <!--WVV tax ID (SS# or EIN)for the organizaton is the extension and the root is required and is 2.16.840.1.113883.4.2-->
89 <id root="2.16.840.1.113883.4.2" extension="002345678"/>
90 </wholeOrganization>
91 </asOrganizationPartOf>
92 </providerOrganization>
93 </patientRole>
94 </recordTarget>
95
96<!--
97*****************************
98Author
99**************
100-->
101 <!-- This example assumes the doctor is creating the report and it is Required. -->
102 <author>
103 <!--WVV Edit time has to be precise at least to the day-->
104 <time value="20100701" />
105 <assignedAuthor>
106 <!--WVP eventually id this is required, the root is fixed -->
107 <!--andn the extension is the SOFTWARE version number assigned by CMS to WV EHR-->
108 <id root="2.16.840.1.113883.3.249.6" extension="100001" />
109 <!--WVVassignedPerson not required-->
110 <assignedPerson>
111 <name>
112 <!--WV Edit-->
113 <given>Nancy</given>
114 <family>Anthracite</family>
115 <suffix>MD</suffix>
116 </name>
117 </assignedPerson>
118 <representedOrganization>
119 <!--WV? id root is OID for the organization so I made one up for this document set-->
120 <id root="2.16.840.1.113883.3.543" extension="1558574526" />
121 <name>WorldVistA Test Clinic</name>
122 </representedOrganization>
123 </assignedAuthor>
124 </author>
125 <!-- The reporting healthcare facility is represented using the CCD "Source of Information" construct, via the Informant participant. -->
126 <informant>
127 <assignedEntity>
128 <!--WV this null flavor is required as is-->
129 <id nullFlavor="NA"/>
130 <representedOrganization>
131 <!--WV root is the OID of the organization. ID is required but name is not and id is OID stated earlier-->
132 <id root="2.16.840.1.113883.3.543" extension="1558574526" />
133 <name>World VistA Test Clinic</name>
134 </representedOrganization>
135 </assignedEntity>
136 </informant>
137
138 <!-- This example assumes that the institution responsible for the data is serving as custodian. -->
139 <!--WV This element is required as is the sSD which is not stated if it is an OID but assumed it is-->
140 <!--WV Name is not required, only ID is required.-->
141 <custodian>
142 <assignedCustodian>
143 <representedCustodianOrganization>
144 <id root="2.16.840.1.113883.3.543" extension="100001" />
145 <name>WorldVistA Test Clinic</name>
146 </representedCustodianOrganization>
147 </assignedCustodian>
148 </custodian>
149
150 <!-- In this example, the author is also serving as legal authenticator. -->
151 <!--WV section is this is not required-->
152<legalAuthenticator>
153 <time value="20100701" />
154 <!--WV the signature code of S is required-->
155 <signatureCode code="S" />
156 <assignedEntity>
157 <!--WV document does not specify the requirements of the id but it is required-->
158 <!--WVP and the sample suggests it is the number below and extension is ???-->
159 <id root="2.16.840.1.113883.3.543" extension="111111" />
160 <assignedPerson>
161 <name>
162 <given>Nancy</given>
163 <family>Anthracite</family>
164 <suffix>MD</suffix>
165 </name>
166 </assignedPerson>
167 <representedOrganization>
168 <!--WV? and is fixed for the WorldVistA Test Clinic in this submitted document series-->
169 <id root="2.16.840.1.113883.3.543" extension="1558574526" />
170 <name>WorldVistA Test Clinic</name>
171 </representedOrganization>
172 </assignedEntity>
173 </legalAuthenticator>
174
175
176
177 <!--Added to sample as it is new since 2008-->
178 <!--WVP permanent for participant in the primary care provider participant-->
179<!--WVP performer type codes are numerous but PRF is performer or the person who did it-->
180 <participant typeCode="PRF">
181 <!--WVP required as is for function-->
182 <!-- WVP I believe PCP is primary care provider but not sure-->
183 <functionCode code="PCP" codeSystem="2.16.840.1.113883.5.88"/>
184 <!--WVP Associated Entity is required ti be there with this PROV-->
185 <associatedEntity classCode="PROV">
186 <!--WV? OID of the provider fixed for this series of documents-->
187 <id root="2.16.840.1.113883.3.249.6" extension="111111" />
188 <!--WV associated person is not required so presumabley the code will suffice not sure??-->
189 <associatedPerson>
190 <name>
191 <prefix>Dr.</prefix>
192 <given>Nancy</given>
193 <family>Anthracite</family>
194 </name>
195 </associatedPerson>
196 </associatedEntity>
197 </participant>
198
199 <!--The service event is the encounter that describes tehe encunter as well as the provider, location and time-->
200 <!--!There can be one or more documentation elements depending on the number of encounters during the reporting period-->
201 <!--WVV IMPORTANT!! The encounter codeds are recorded here-->
202 <!-- They are in appendix B of the downloadable resource document-->
203 <!-- Each documentation of is a single service event-->
204
205<!--Occurence of Measures episode documention-->
206<!--Like an encounter section only for QRDA-->
207<!--Same doctor, same clinic, different date and different enconter code-->
208
209
210 <!--First Visit documentationOf section-->
211
212 <documentationOf>
213 <serviceEvent>
214 <!--WV serviceEvent codes from Tab B from the downloadabe resource coding system is -->
215 <!--WVF codeSystem is 2.16.840.1.113883 -->
216 <!--WV code root shall be WVP 2.16.840.1.113883.6.12 and the extension shall be the encounter code -->
217 <!-- WV? like the length of visit and complexity codes for example-->
218
219 <code code="99202" codeSystem="2.16.840.1.113883.6.12" codeSystemName="C4"/>
220 <effectiveTime>
221 <!--WV Edit-->
222 <!-- This has to be precise at least to the day. Something with time would be better. Not sure of the necessary format so did not add time-->
223 <low value="20100210"/>
224 <high value="20100210"/>
225 </effectiveTime>
226 <performer typeCode="PRF">
227 <assignedEntity>
228 <!-- WV? Provider NPI Required root 2.16.840.1.113883.9.96 is ?? and the NPI is an extension for the provider-->
229 <!--This is variable but may remain unchanged for this document set-->
230 <id root="2.16.840.1.113883.4.6" extension="6558574524"/>
231 <!--<id root="2.16.840.1.113883.3.543" extension="1457402711"/>-->
232 <!--WV this element should be present and the code is probably for a General Physician for!-->
233 <!--It may be the type of provider as the example as I think 2.16.840.1.113883.6.69is the NDC-->
234 <!-- codeSystemName is SNOMED CT and code is an 8 digit num and display name is for a physician-->
235 <!--O6120 is SPECIALIZED PHYSICIAN when I looked it up so I don't know where to look for this 8 digit number-->
236 <!-- http://terminology.vetmed.vt.edu/SCT/menu.cfm to look up codes-->
237 <!--59058001 is general physician ;Family Medicine specialist is 62247001-->
238 <code code="62247001" codeSystem="2.16.840.1.113883.6.69" codeSystemName="SNM" displayName="Internal Medician Specialist"/>
239 <addr>
240 <streetAddressLine>123 Maple Ave</streetAddressLine>
241 <city>Gaithersburg</city>
242 <state>MD</state>
243 <postalCode>20877</postalCode>
244 </addr>
245 <assignedPerson>
246 <name>
247 <given>Nancy</given>
248 <family>Anthracite</family>
249 <suffix>MD</suffix>
250 </name>
251 </assignedPerson>
252 </assignedEntity>
253 </performer>
254 </serviceEvent>
255 </documentationOf>
256
257
258 <!--Second Visit documentationOf section-->
259
260 <documentationOf>
261 <serviceEvent>
262 <!--WV serviceEvent codes from Tab B from the downloadabe resource coding system is -->
263 <!--WVF codeSystem is 2.16.840.1.113883 -->
264 <!--WV code root shall be WVP 2.16.840.1.113883.6.12 and the extension shall be the encounter code -->
265 <!-- WV? like the length of visit and complexity codes for example-->
266
267 <code code="99204" codeSystem="2.16.840.1.113883.6.12" codeSystemName="C4"/>
268 <effectiveTime>
269 <!--WV Edit-->
270 <!-- This has to be precise at least to the day. Something with time would be better. Not sure of the necessary format so did not add time-->
271 <low value="20100701"/>
272 <high value="20100701"/>
273 </effectiveTime>
274 <performer typeCode="PRF">
275 <assignedEntity>
276 <!--WVP 2.16.840.1.113883.4.6 for assigned entity with NPI extension-->
277 <id root="2.16.840.1.113883.4.6" extension="6558574524"/>
278 <!--<id root="2.16.840.1.113883.3.543" extension="1457402711"/>-->
279 <!--WV this element should be present and the code is probably for a General Physician for!-->
280 <!--It may be the type of provider as the example as I think 2.16.840.1.113883.6.69is the NDC-->
281 <!-- codeSystemName is SNOMED CT and code is an 8 digit num and display name is for a physician-->
282 <!--O6120 is SPECIALIZED PHYSICIAN when I looked it up so I don't know where to look for this 8 digit number-->
283 <!-- http://terminology.vetmed.vt.edu/SCT/menu.cfm to look up codes-->
284 <!--59058001 is general physician ;Family Medicine specialist is 62247001-->
285 <code code="62247001" codeSystem="2.16.840.1.113883.6.69" codeSystemName="SNM" displayName="Internal Medician Specialist"/>
286 <addr>
287 <streetAddressLine>123 Maple Ave</streetAddressLine>
288 <city>Gaithersburg</city>
289 <state>MD</state>
290 <postalCode>20877</postalCode>
291 </addr>
292 <assignedPerson>
293 <name>
294 <given>Nancy</given>
295 <family>Anthracite</family>
296 <suffix>MD</suffix>
297 </name>
298 </assignedPerson>
299 </assignedEntity>
300 </performer>
301 </serviceEvent>
302 </documentationOf>
303 <!--
304********************************************************
305CDA Body
306********************************************************
307-->
308 <component>
309 <structuredBody>
310 <!--
311 ********************************************************
312 Measure Set Section
313 ********************************************************
314 -->
315 <component>
316 <section>
317 <!-- WVP QRDA Category I measure-specific template ID for 2010 #1. -->
318 <!--WP Next 3 lines do not change during the reporting period, for the measures section-->
319 <templateId root="2.16.840.1.113883.3.249.11.50" />
320 <code code="55185-3" codeSystem="2.16.840.1.113883.6.1" />
321 <title>Measure set: CMS EHR Measure Set</title>
322 <text>2010 Measures Set Measures</text>
323 <!--
324 ***************************************************
325 Measure Section
326 ***************************************************
327 -->
328 <component>
329 <section>
330 <!--template ID for each measure being reported-->
331 <templateId root="2.16.840.1.113883.3.249.11.2" />
332 <templateId root="2.16.840.1.113883.3.249.11.3" />
333 <templateId root="2.16.840.1.113883.3.249.11.4" />
334 <templateId root="2.16.840.1.113883.3.249.11.5" />
335 <templateId root="2.16.840.1.113883.3.249.11.6" />
336 <templateId root="2.16.840.1.113883.3.249.11.7" />
337 <templateId root="2.16.840.1.113883.3.249.11.8" />
338 <templateId root="2.16.840.1.113883.3.249.11.9" />
339 <templateId root="2.16.840.1.113883.3.249.11.10" />
340 <templateId root="2.16.840.1.113883.3.249.11.11" />
341 <templateId root="2.16.840.1.113883.3.249.11.15" />
342 <!--New for 2011-->
343 <templateId root="2.16.840.1.113883.3.249.11.51" />
344 <templateId root="2.16.840.1.113883.3.249.11.52" />
345 <templateId root="2.16.840.1.113883.3.249.11.53" />
346 <templateId root="2.16.840.1.113883.3.249.11.54" />
347 <templateId root="2.16.840.1.113883.3.249.11.55" />
348 <templateId root="2.16.840.1.113883.3.249.11.56" />
349 <templateId root="2.16.840.1.113883.3.249.11.57" />
350 <templateId root="2.16.840.1.113883.3.249.11.58" />
351 <templateId root="2.16.840.1.113883.3.249.11.59" />
352 <templateId root="2.16.840.1.113883.3.249.11.60" />
353 <code code="55186-1" codeSystem="2.16.840.1.113883.6.1" />
354
355 <title>Measure Section</title>
356 <!--Here is where the HTML begins for the above and it is optional-->
357 <text>
358 <list>
359 <item>CMS Measure #1: Diabetes Mellitus: Hemoglobin A1c Poor Control in Diabetes Mellitus</item>
360 <item>CMS Measure #2: Diabetes Mellitus: Low Density Lipoprotein (LDL-C) Control in Diabetes Mellitus</item>
361 <item>CMS Measure #3: Diabetes Mellitus: High Blood Pressure Control in Diabetes Mellitus</item>
362 <item>CMS Measure #5: Heart Failure: Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)</item>
363 <item>CMS Measure #7: Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI)</item>
364 <item>CMS Measure #110: Preventive Care and Screening: Influenza Immunization for Patients >= 50 Years</item>
365 <item>CMS Measure #111: Preventive Care and Screening: Pneumonia Vaccination for Patients 65 Years and Older</item>
366 <item>CMS Measure #112: Preventive Care and Screening: Screening Mammography</item>
367 <item>CMS Measure #113: Preventive Care and Screening: Colorectal Cancer Screening</item>
368 <item>CMS Measure #124: Health Information Technology (HIT): Adoption/Use of Electronic Health Records (EHR)</item>
369 <item>CMS Measure eRx:Adoption/Use of Medication Electronic Prescribing Measure</item>
370 <!--added 2011 measures-->
371 <item>CMS Measure #39: Screening or Therapy for Osteoporosis for Women Aged 65 Years and Older</item>
372 <item>CMS Measure #47: Advance Care Plan </item>
373 <item>CMS Measure #48: Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older</item>
374 <item>CMS Measure #128: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up </item>
375 <item>CMS Measure #173: Preventive Care and Screening: Unhealthy Alcohol Use - Screening</item>
376 <item>CMS Measure #0013: Hypertension (HTN): Blood Pressure Measurement - QRDA Cat I template </item>
377 <item>CMS Measure #0022: Drugs to be avoided in the Elderly </item>
378 <item>CMS Measure #0024: Body Mass Index (BMI) 2 through 18 years of age </item>
379 <item>CMS Measure #0028: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention</item>
380 <item>CMS Measure #0038: Childhood Immunization Status - QRDA Cat I template</item>
381 </list>
382 </text>
383 <!--Begin listing of acts-->
384 <entry typeCode="DRIV">
385 <act classCode="ACT" moodCode="DEF">
386
387 <code code="PQRI-1" codeSystem="2.16.840.1.113883.3.249.12" displayName="Hemoglobin A1c Poor Control in Diabetes Mellitus"/>
388 <text>Percentage of patients 18 through 75 years with diabetes mellitus who had most recent hemoglobin A1C greater than 9.0%</text>
389 <statusCode code="completed"/>
390 </act>
391 </entry>
392 <entry typeCode="DRIV">
393 <act classCode="ACT" moodCode="DEF">
394
395 <code code="PQRI-2" codeSystem="2.16.840.1.113883.3.249.12" displayName="Low Density Lipoprotein (LDL-C) Control in Diabetes Mellitus"/>
396 <text>Percentage of patients 18 through 75 years with diabetes mellitus who had most recent LDL-C level in control (less than 100 mg./dL)</text>
397 <statusCode code="completed"/>
398 </act>
399 </entry>
400 <entry typeCode="DRIV">
401 <act classCode="ACT" moodCode="DEF">
402
403 <code code="PQRI-3" codeSystem="2.16.840.1.113883.3.249.12" displayName="Hemoglobin A1c Poor Control in Diabetes Mellitus"/>
404 <text>Percentage of patients 18 through 75 years with diabetes mellitus who had most recent blood pressure in control (less than 140/80 mmHg)</text>
405 <statusCode code="completed"/>
406 </act>
407 </entry>
408 <entry typeCode="DRIV">
409 <act classCode="ACT" moodCode="DEF">
410
411 <code code="PQRI-5" codeSystem="2.16.840.1.113883.3.249.12" displayName="Heart Failure: Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)"/>
412 <text>Percentage of patients 18 years and older with a diagnosis of heart frilure and LVSD who were prescribed ACE inhibitor or ARB therapy</text>
413 <statusCode code="completed"/>
414 </act>
415 </entry>
416 <entry typeCode="DRIV">
417 <act classCode="ACT" moodCode="DEF">
418
419 <code code="PQRI-7" codeSystem="2.16.840.1.113883.3.249.12" displayName="Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction"/>
420 <text>Percentage of patients 18 aged 18 years and older wit a diagnosis of CAD and prior MI who were prescribed beta-blocker therapy</text>
421 <statusCode code="completed"/>
422 </act>
423 </entry>
424 <entry typeCode="DRIV">
425 <act classCode="ACT" moodCode="DEF">
426
427 <code code="PQRI-110" codeSystem="2.16.840.1.113883.3.249.12" displayName="Influenza Immunization for Patients >= 50 Years"/>
428 <text>Percentage of patients aged 50 years and older who received an influenza immunization during the flu season (September through February)</text>
429 <statusCode code="completed"/>
430 </act>
431 </entry>
432 <entry typeCode="DRIV">
433 <act classCode="ACT" moodCode="DEF">
434
435 <code code="PQRI-111" codeSystem="2.16.840.1.113883.3.249.12" displayName="Pneumonia Vaccination for Patients 65 Years and Older"/>
436 <text>Percentage of patients afed 65 years and older who have ever received a pneumoccal vaccine</text>
437 <statusCode code="completed"/>
438 </act>
439 </entry>
440 <entry typeCode="DRIV">
441 <act classCode="ACT" moodCode="DEF">
442
443 <code code="PQRI-112" codeSystem="2.16.840.1.113883.3.249.12" displayName="Screening Mammography"/>
444 <text>Percentage of womaen aged 40 through 69 years who had a mammogram to screen for breast cancer within 24 months</text>
445 <statusCode code="completed"/>
446 </act>
447 </entry>
448 <entry typeCode="DRIV">
449 <act classCode="ACT" moodCode="DEF">
450
451 <code code="PQRI-113" codeSystem="2.16.840.1.113883.3.249.12" displayName="Colorectal Cancer Screening"/>
452 <text>Percentage of patients aged 50 through 80 who received the appropriate colorectal cancer screening</text>
453 <statusCode code="completed"/>
454 </act>
455 </entry>
456 <entry typeCode="DRIV">
457 <act classCode="ACT" moodCode="DEF">
458
459 <code code="PQRI-124" codeSystem="2.16.840.1.113883.3.249.12" displayName="Adoption/Use of Electronic Health Records (EHR)"/>
460 <text>Documents whether provider has adopted and is using health information technology. To qualify, the provider must havea adopted and be using a certified/qualified electronic health record (EHR)</text>
461 <statusCode code="completed"/>
462 </act>
463 </entry>
464 <entry typeCode="DRIV">
465 <act classCode="ACT" moodCode="DEF">
466
467 <code code="eRx" codeSystem="2.16.840.1.113883.3.249.12" displayName="Adoption/Use of Medication Electronic Prescribing Measure"/>
468 <text>Documents whether provider has adopted and is using ePrescribing</text>
469 <statusCode code="completed"/>
470 </act>
471 </entry>
472
473 <!--******************************************
474 Begin 2011 measures
475 ********************************************-->
476 <entry typeCode="DRIV">
477 <act classCode="ACT" moodCode="DEF">
478
479 <code code="PQRI-39" codeSystem="2.16.840.1.113883.3.249.12" displayName="Screening or Therapy for Osteoporosis for Women Aged 65 Years and Older"/>
480 <text>Percentage of patients who had a DXA measurement ordered or performed at least once since age 60 or pharmacologic therapy prescribed within 12 months before the end of the measurement period</text>
481 <statusCode code="completed"/>
482 </act>
483 </entry>
484 <entry typeCode="DRIV">
485 <act classCode="ACT" moodCode="DEF">
486
487 <code code="PQRI-47" codeSystem="2.16.840.1.113883.3.249.12" displayName="Advance Care Plan"/>
488 <text>Percentage of patients age 65 and older who have an advanced care plan or surrogate decision maker documented in the medical record or documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan.</text>
489 <statusCode code="completed"/>
490 </act>
491 </entry>
492 <entry typeCode="DRIV">
493 <act classCode="ACT" moodCode="DEF">
494
495 <code code="PQRI-48" codeSystem="2.16.840.1.113883.3.249.12" displayName="Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older"/>
496 <text>Percentage of patients equal to or older than 65 years of age at the beginning of the measurement perion who were assesed for the presence or absence of urinary incontinence within 12 months.</text>
497 <statusCode code="completed"/>
498 </act>
499 </entry>
500 <entry typeCode="DRIV">
501 <act classCode="ACT" moodCode="DEF">
502
503 <code code="PQRI-128" codeSystem="2.16.840.1.113883.3.249.12" displayName="Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up"/>
504 <text>Percentage of patients aged 18 yesrs and older with a calculate BMI in the past 6 months or during the current visit documented in the medical record and if the most recent BMI is ourtide parameters, a follow-up plan is documented. Ages 65 and older BMI equal to or greater than 30 or less than 22 and ages 18-64, BMI greater than or equal to 25 or less than 18.5</text>
505 <statusCode code="completed"/>
506 </act>
507 </entry>
508 <entry typeCode="DRIV">
509 <act classCode="ACT" moodCode="DEF">
510
511 <code code="PQRI-173" codeSystem="2.16.840.1.113883.3.249.12" displayName="Preventive Care and Screening: Unhealthy Alcohol Use - Screening"/>
512 <text>Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic method within 24 months</text>
513 <statusCode code="completed"/>
514 </act>
515 </entry>
516 <entry typeCode="DRIV">
517 <act classCode="ACT" moodCode="DEF">
518
519 <code code="PQRI-13" codeSystem="2.16.840.1.113883.3.249.12" displayName="Hypertension (HTN): Blood Pressure Measurement"/>
520 <text>Percentage of patients aged 18 years and older with a diagnosis of hypertension in the beginning of the measurement period with a blood pressure recoreded.</text>
521 <statusCode code="completed"/>
522 </act>
523 </entry>
524 <entry typeCode="DRIV">
525 <act classCode="ACT" moodCode="DEF">
526
527 <code code="PQRI-22" codeSystem="2.16.840.1.113883.3.249.12" displayName="Drugs to be avoided in the elderly"/>
528 <text>Percentage of patients aged 65 years and older who received at least one drug to be acoided in the elderly and/or two different drugs to be avoided in the elderly in the measurement period</text>
529 <statusCode code="completed"/>
530 </act>
531 </entry>
532 <entry typeCode="DRIV">
533 <act classCode="ACT" moodCode="DEF">
534
535 <code code="PQRI-24" codeSystem="2.16.840.1.113883.3.249.12" displayName="BMI age 2-18 years of age"/>
536 <text>Percentage of children 2-18 years of age at the beginning of the measurement period whose weight is classified based on BMI percentile for age and gender.</text>
537 <statusCode code="completed"/>
538 </act>
539 </entry>
540 <entry typeCode="DRIV">
541 <act classCode="ACT" moodCode="DEF">
542
543 <code code="PQRI-28" codeSystem="2.16.840.1.113883.3.249.12" displayName="Preventive care and Screening: Tobacco Use: Screening and Cessation Intervention"/>
544 <text>Percentage of patients aged 18 years of older who were screened about tobacco use at least once during the two year measurement preoid AND who received cessation counseling if identified as a tobacco user.</text>
545 <statusCode code="completed"/>
546 </act>
547 </entry>
548 <entry typeCode="DRIV">
549 <act classCode="ACT" moodCode="DEF">
550
551 <code code="PQRI-38" codeSystem="2.16.840.1.113883.3.249.12" displayName="Childhood immumnization status"/>
552 <text>Percentage of children who turn two years of age during the measurement period who have had four DTaP/DT, three IPV, one MMR and three H influenza type B, three hepatitis B, one chicken pox vaccine (VZV) and four pneumococcal conjugate vaccines by their second birthday</text>
553 <statusCode code="completed"/>
554 </act>
555 </entry>
556 <entry typeCode="DRIV">
557 <act classCode="ACT" moodCode="DEF">
558
559 <code code="" codeSystem="2.16.840.1.113883.3.249.12" displayName=""/>
560 <text>Documents whether provider has adopted and is using ePrescribing</text>
561 <statusCode code="completed"/>
562 </act>
563 </entry>
564 <!--
565 *******************************
566 Reporting Parameters Section
567 *****************************
568 -->
569 <component>
570 <section>
571 <code code="55187-9" codeSystem="2.16.840.1.113883.6.1"/>
572 <title>Reporting Parameters</title>
573 <text>
574 <list>
575 <item>Reporting Period Jan 1, 2010 to Dec 31, 2010</item>
576 </list>
577 </text>
578 <entry>
579 <act classCode="ACT" moodCode="EVN">
580 <code code="252116004" codeSystem="2.16.840.1.113883.6.96" displayName="Observation Parameters"/>
581 <effectiveTime>
582 <low value="20100101"/>
583 <high value="20101231"/>
584 </effectiveTime>
585 </act>
586 </entry>
587 </section>
588 </component>
589 <!--
590 ********************************************************
591 Patient Data
592 ********************************************************
593 -->
594 <component>
595 <section>
596 <code code="55188-7" codeSystem="2.16.840.1.113883.6.1"/>
597 <title>Patient Data</title>
598 </section>
599 </component>
600 <!--
601 **************************************************
602 PROBLEM SECTION
603 **************************************************
604 -->
605
606 <component>
607 <section>
608 <!--Problems are observations and the next two lines are fixed -WVP-->
609 <templateId root="2.16.840.1.113883.10.20.1.11"/>
610 <code code="11450-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Problem list"/>
611 <title>Problems</title>
612 <text>
613 <table border="1" width="100%">
614 <tbody>
615 <tr>
616 <th>Condition</th>
617 <th>Effective Dates</th>
618 <th>Condition Status</th>
619 </tr>
620 <tr>
621 <td>Diabetes mellitus</td>
622 <td>2001</td>
623 <td>Active/Chronic</td>
624 </tr>
625 <tr>
626 <td>Congestive Heart Failure</td>
627 <td>2003</td>
628 <td>Active/Chronic</td>
629 </tr>
630 <tr>
631 <td>Myocardial Infactioon</td>
632 <td>2003</td>
633 <td>Resolved</td>
634 </tr>
635 </tbody>
636 </table>
637 </text>
638 <!--DRIV is derived from and both source and target are observations Next three lines are WVP-->
639 <entry typeCode="DRIV">
640 <act classCode="ACT" moodCode="EVN">
641 <templateId root="2.16.840.1.113883.10.20.1.27"/>
642 <!-- Problem act template -->
643 <!--This is a UID for this problem-->
644 <id root="82826640-8669-11df-a4ee-0800200c9c66"/>
645 <code nullFlavor="NA"/>
646 <!--relates an aCT to a subject act that the first act is primarily concerned with-->
647 <entryRelationship typeCode="SUBJ">
648 <observation classCode="OBS" moodCode="EVN">
649 <!--10.20.1.50 is for observation-->
650 <templateId root="2.16.840.1.113883.10.20.1.28"/>
651 <!-- Problem observation template -->
652 <id root="82826641-8669-11df-a4ee-0800200c9c66"/>
653 <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
654 <statusCode code="completed"/>
655 <effectiveTime>
656 <low value="20010101"/>
657 </effectiveTime>
658 <!--CONF-QRDA1-166 follows-->
659 <code code="64572001" type="CD" displayName="condition" codeSystem="2.16.840.1.113883.6.96"/>
660 <!--CD is a concept descriptor and the code systeem is ICD9 for 6.103 -->
661 <value xsi:type="CD" code="250.00" codeSystem="2.16.840.1.113883.6.103" displayName="Diabetes Mellitus"/>
662 <!--REFR is refers to-->
663 <entryRelationship typeCode="REFR">
664 <!-- EVN is event or a service that actually happens-->
665 <observation classCode="OBS" moodCode="EVN">
666 <!--10.20.1.50 is observation template OID-->
667 <templateId root="2.16.840.1.113883.10.20.1.50"/>
668 <!-- Problem status observation template -->
669 <!--33999-4 is for status template-->
670 <code code="33999-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Status"/>
671 <statusCode code="completed"/>
672 <!--55561003 is fro active CE is for coded with equivalents data type and 2.16.840.1.113883.6.96 is SNOMED CT. This is CONF-QRDA1-168 and comes from the downloadable resource tab C-->
673 <value xsi:type="CE" code="90734009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNM" displayName="Chronic"/>
674 </observation>
675 </entryRelationship>
676 </observation>
677 </entryRelationship>
678 </act>
679 </entry>
680 <!--DRIV is derived from and both source and target are observations Next three lines are WVP-->
681 <entry typeCode="DRIV">
682 <act classCode="ACT" moodCode="EVN">
683 <templateId root="2.16.840.1.113883.10.20.1.27"/>
684 <!-- Problem act template -->
685 <!--This is a UID for this problem-->
686 <id root="82dd6642-8669-11df-a4ee-0800200c9c66"/>
687 <code nullFlavor="NA"/>
688 <!--relates an aCT to a subject act that the first act is primarily concerned with-->
689 <entryRelationship typeCode="SUBJ">
690 <observation classCode="OBS" moodCode="EVN">
691 <!--10.20.1.50 is for observation-->
692 <templateId root="2.16.840.1.113883.10.20.1.28"/>
693 <!-- Problem observation template -->
694 <id root="82826643-8669-11df-a4ee-0800200c9c66"/>
695 <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
696 <statusCode code="completed"/>
697 <effectiveTime>
698 <low value="20030101"/>
699 </effectiveTime>
700 <code code="64572001" type="CD" displayName="condition" codeSystem="2.16.840.1.113883.6.96"/>
701 <!--CD is a concept descriptor and the code systeem is ICD9 for 6.103 -->
702 <value xsi:type="CD" code="428.0" codeSystem="2.16.840.1.113883.6.103" displayName="Congestive Heart Failure"/>
703 <!--REFR is refers to-->
704 <entryRelationship typeCode="REFR">
705 <!-- EVN is event or a service that actually happens-->
706 <observation classCode="OBS" moodCode="EVN">
707 <!--10.20.1.50 is observation template OID-->
708 <templateId root="2.16.840.1.113883.10.20.1.50"/>
709 <!-- Problem status observation template -->
710 <!--33999-4 is for status template-->
711 <code code="33999-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Status"/>
712 <statusCode code="completed"/>
713 <!--55561003 is fro active CE is for coded with equivalents data type and 6.96 is SNOMED CT-->
714 <value xsi:type="CE" code="90734009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNM" displayName="Chronic"/>
715 </observation>
716 </entryRelationship>
717 </observation>
718 </entryRelationship>
719 </act>
720 </entry>
721 <entry typeCode="DRIV">
722 <act classCode="ACT" moodCode="EVN">
723 <templateId root="2.16.840.1.113883.10.20.1.27"/>
724 <!-- Problem act template -->
725 <!--This is a UID for this problem-->
726 <id root="82826640-8669-11df-a4ee-0800200c9c66"/>
727 <code nullFlavor="NA"/>
728 <!--relates an aCT to a subject act that the first act is primarily concerned with-->
729 <entryRelationship typeCode="SUBJ">
730 <observation classCode="OBS" moodCode="EVN">
731 <!--10.20.1.50 is for observation-->
732 <templateId root="2.16.840.1.113883.10.20.1.28"/>
733 <templateId root="2.16.840.1.113883.3.249.11.100.8"/>
734 <!-- Problem observation template -->
735 <id root="82826641-8669-11df-a4ee-0800200c9c66"/>
736 <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
737 <statusCode code="completed"/>
738 <effectiveTime>
739 <low value="20030101"/>
740 </effectiveTime>
741 <code code="64572001" type="CD" displayName="condition" codeSystem="2.16.840.1.113883.6.96"/>
742 <!--CD is a concept descriptor and the code systeem is ICD9 for 6.103 -->
743 <value xsi:type="CD" code="412" codeSystem="2.16.840.1.113883.6.103" displayName="Old Myocardial Infarction"/>
744 <!--REFR is refers to-->
745 <entryRelationship typeCode="REFR">
746 <!-- EVN is event or a service that actually happens-->
747 <observation classCode="OBS" moodCode="EVN">
748 <!--10.20.1.50 is observation template OID-->
749 <templateId root="2.16.840.1.113883.10.20.1.50"/>
750 <templateId root="2.16.840.1.113883.3.249.11.100.12"/>
751 <!--33999-4 is for status template-->
752 <code code="33999-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Status"/>
753 <statusCode code="completed"/>
754 <!--55561003 is fro active CE is for coded with equivalents data type and 6.96 is SNOMED CT-->
755 <value xsi:type="CE" code="73425007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNM" displayName="Inactive"/>
756 </observation>
757 </entryRelationship>
758 <entryRelationship>
759 <observation classCode="OBS" moodCode="EVN">
760 <templateId root="2.16.840.1.113883.10.20.1.51"/>
761 <code code="11323-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Health status"/>
762 <statusCode code="completed"/>
763 <value xsi:type="CE" code="161901003" displayName="Chronically ill" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNM"/>
764 </observation>
765 </entryRelationship>
766 </observation>
767 </entryRelationship>
768 </act>
769 </entry>
770 </section>
771 </component>
772 <!--
773 *********************************************
774 Medication Section
775 *********************************************
776 -->
777 <component>
778 <section>
779 <!--<templateId root="2.16.840.1.113883.3.88.11.83.112" assigningAuthorityName="HITSP/C83"/>-->
780 <!--<templateId root="1.3.6.1.4.1.19376.1.5.3.1.3.19" assigningAuthorityName="IHE PCC"/>-->
781 <templateId root="2.16.840.1.113883.10.20.1.8" assigningAuthorityName="HL7 CCD"/>
782 <code code="10160-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="History of medication use"/>
783 <title>Medications</title>
784 <text>
785 <table border="1" width="100%">
786 <thead>
787 <tr>
788 <th>Medication</th>
789 <th>Date</th>
790 <th>Status</th>
791 <th>Form</th>
792 <th>Strength</th>
793 <th>Quantity</th>
794 <th>SIG</th>
795 <th>Refills</th>
796 <th>Prescribed by</th>
797 </tr>
798 </thead>
799 <tbody>
800 <tr>
801 <td>GLYBURIDE-METFORMIN 5.0 mg-500 mg oral tablet</td>
802 <td>7-1-2010</td>
803 <td>ACTIVE</td>
804 <td>TABLET</td>
805 <td>5.0/500 MG</td>
806 <td>90 TAB</td>
807 <td> ONE BY MOUTH Q12H</td>
808 <td>two</td>
809 <td>Nancy Anthracite, MD</td>
810 </tr>
811 <tr>
812 <td>ATENOLOL 50MG TAB</td>
813 <td>7-1-2010</td>
814 <td>ACTIVE</td>
815 <td>TAB</td>
816 <td>50 MG</td>
817 <td>90 TAB</td>
818 <td>ONE TAB (BY MOUTH) QD</td>
819 <td>TWO</td>
820 <td>Nancy Anthracite, MD</td>
821 </tr>
822 <tr>
823 <td>LISINOPRIL 10MG TAB</td>
824 <td>7-1-2010</td>
825 <td>ACTIVE</td>
826 <td>TAB</td>
827 <td>10 MG</td>
828 <td>90 TAB</td>
829 <td>ONE TAB ORAL (BY MOUTH) QAM</td>
830 <td>2</td>
831 <td>Nancy Anthracite, MD</td>
832 </tr>
833 </tbody>
834 </table>
835 </text>
836 <entry typeCode="DRIV">
837 <!-- WVP EVN mood code is for event or a service that actually happens-->
838 <substanceAdministration classCode="SBADM" moodCode="EVN">
839 <!--WVP Substance Adminstration Template 10.20.1.24 what is administered but 10.20.1.34 would be for supply activity-->
840 <templateId root="2.16.840.1.113883.10.20.1.24" assigningAuthorityName="CCD"/>
841 <templateId root="2.16.840.1.113883.3.249.19.5.10" extension="10016"/>
842 <!--<id root="1.3.6.1.4.1.19376.1.5.3.1.4.7.1" assigningAuthorityName="IHE PCC"/>-->
843 <!--<id root="MED1" extension="CCRObjectID"/>-->
844 <id root="2.16.840.1.113883.19.5.10" extension="100020"/>
845 <statusCode code="completed"/>
846 <effectiveTime xsi:type="IVL_TS">
847 <low value="20100701"/>
848 <high nullFlavor="UNK"/>
849
850 </effectiveTime>
851 <effectiveTime xsi:type="PIVL_TS" operator="A">
852 <period value="12" unit="h"/>
853 </effectiveTime>
854 <!--SHOULD have this routeOfAdminstartionbut I can't find the codes for it-->
855 <!--Downloadable resource is missing them-->
856 <!--<routeCode displayName="" code="" codeSystemName="2.16.840.1.113883.5.112"/>-->
857 <doseQuantity value="1">
858 <!--Unit was missing from generated CCD MG was added (hope it is right!)-->
859 <low value="1" unit="TAB"/>
860 <high value="1" unit="TAB"/>
861 </doseQuantity>
862 <consumable>
863 <manufacturedProduct>
864 <!--<templateId root="2.16.840.1.113883.3.88.11.83.8.2" assigningAuthorityName="HITSP C83"/>-->
865 <templateId root="2.16.840.1.113883.10.20.1.53" assigningAuthorityName="CCD"/>
866 <!--<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7.2" assigningAuthorityName="IHE PCC"/>-->
867 <manufacturedMaterial>
868 <!--this will be right RxNorm in 2011-->
869 <!--Other options to use
870 00087607311 glyBURIDE-metformin 2.5 mg-500 mg oral tablet
871 00087607411 glyBURIDE-metformin 5 mg-500 mg oral tablet
872 00087607731 glipiZIDE-metformin 2.5 mg-500 mg oral tablet
873 00087607831 glipiZIDE-metformin 5 mg-500 mg oral tablet
874 00087608131 glipiZIDE-metformin 2.5 mg-250 mg oral tablet-->
875
876 <code code="00087607411" displayName="glyburide-metformin 2.5 mg-500 mg oral tablet" codeSystemName="NDC" codeSystem="2.16.840.1.113883.6.69">
877 <!--<name/>-->
878 <originalText>glyburide-metformin</originalText>
879 </code>
880 </manufacturedMaterial>
881 </manufacturedProduct>
882 </consumable>
883 </substanceAdministration>
884 </entry>
885 <entry typeCode="DRIV">
886 <substanceAdministration classCode="SBADM" moodCode="EVN">
887 <templateId root="2.16.840.1.113883.10.20.1.24" assigningAuthorityName="CCD"/>
888 <!--<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7.1" assigningAuthorityName="IHE PCC"/>-->
889 <!--<id root="MED2" extension="CCRObjectID"/>-->
890 <id root="2.16.840.1.113883.19.5.10" extension="100016"/>
891 <statusCode code="completed"/>
892 <effectiveTime xsi:type="IVL_TS">
893 <low value="20100701"/>
894 <high nullFlavor="UNK"/>
895 </effectiveTime>
896 <effectiveTime xsi:type="PIVL_TS" operator="A">
897 <period value="12" unit="h"/>
898 </effectiveTime>
899 <!--SHOULD have this routeOfAdminstartionbut I can't find the codes for it-->
900 <!--Downloadable resource is missing them-->
901 <!--<routeCode displayName="" code="" codeSystemName="2.16.840.1.113883.5.112"/>-->
902 <doseQuantity value="1">
903 <!--Unit was missing from generated CCD MG was added (hope it is right!)-->
904 <low value="1" unit="TAB"/>
905 <high value="1" unit="TAB"/>
906 </doseQuantity>
907 <consumable>
908 <manufacturedProduct>
909 <!--<templateId root="2.16.840.1.113883.3.88.11.83.8.2" assigningAuthorityName="HITSP C83"/>-->
910 <templateId root="2.16.840.1.113883.10.20.1.53" assigningAuthorityName="CCD"/>
911 <!--<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7.2" assigningAuthorityName="IHE PCC"/>-->
912 <manufacturedMaterial>
913 <!--not valid until 2011-->
914 <!--<code displayName="ATENOLOL 100MG TAB" code="197379" codeSystemName="RXNORM" codeSystem=""/>-->
915 <!--Other Options
916 00005321843 atenolol 25 mg oral tablet Atenolol
917 00005321934 atenolol 50 mg oral tablet Atenolol
918 00005321943 atenolol 50 mg oral tablet Atenolol
919 00005322034 atenolol 100 mg oral tablet Atenolol
920 00005322043 atenolol 100 mg oral tablet Atenolol
921 -->
922 <code code="00005322034" displayName="ATENOLOL 50MG TAB" codeSystemName="NDC" codeSystem="2.16.840.1.113883.6.69">
923 <!--<name/>-->
924 <originalText>atenolol</originalText>
925 </code>
926 </manufacturedMaterial>
927 </manufacturedProduct>
928 </consumable>
929 </substanceAdministration>
930 </entry>
931 <entry typeCode="DRIV">
932 <substanceAdministration classCode="SBADM" moodCode="EVN">
933 <templateId root="2.16.840.1.113883.10.20.1.24" assigningAuthorityName="CCD"/>
934 <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7.1" assigningAuthorityName="IHE PCC"/>
935 <id root="2.16.840.1.113883.19.5.10" extension="100016"/>
936 <statusCode code="completed"/>
937 <effectiveTime xsi:type="IVL_TS">
938 <low value="20100703"/>
939 <high nullFlavor="UNK"/>
940 </effectiveTime>
941 <!--<routeCode displayName="" code="" codeSystemName="2.16.840.1.113883.5.112"/>-->
942 <doseQuantity>
943 <low value="10" unit="MG"/>
944 <high value="10" unit="MG"/>
945 </doseQuantity>
946 <consumable>
947 <manufacturedProduct>
948 <templateId root="2.16.840.1.113883.3.88.11.83.8.2" assigningAuthorityName="HITSP C83"/>
949 <templateId root="2.16.840.1.113883.10.20.1.53" assigningAuthorityName="CCD"/>
950 <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7.2" assigningAuthorityName="IHE PCC"/>
951 <!--Other options
952 00006001528 lisinopril 2.5 mg oral tablet
953 00006001531 lisinopril 2.5 mg oral tablet
954 00006001558 lisinopril 2.5 mg oral tablet
955 00006001928 lisinopril 5 mg oral tablet
956 00006001954 lisinopril 5 mg oral tablet
957 00006001958 lisinopril 5 mg oral tablet
958 00006001972 lisinopril 5 mg oral tablet
959 00006001982 lisinopril 5 mg oral tablet
960 00006001987 lisinopril 5 mg oral tablet
961 00006001994 lisinopril 5 mg oral tablet
962 00006010628 lisinopril 10 mg oral tablet
963 00006010631 lisinopril 10 mg oral tablet
964 00006010654 lisinopril 10 mg oral tablet
965 00006010658 lisinopril 10 mg oral tablet
966 00006010672 lisinopril 10 mg oral tablet
967 00006010682 lisinopril 10 mg oral tablet
968 00006010686 lisinopril 10 mg oral tablet
969 00006010687 lisinopril 10 mg oral tablet
970 00006010694 lisinopril 10 mg oral tablet
971 -->
972
973
974 <manufacturedMaterial>
975 <code displayName="LISINOPRIL 10 MG TAB" code="00006010628" codeSystemName="NDC" codeSystem="2.16.840.1.113883.6.69">
976 <originalText>lisinopril</originalText>
977 </code>
978 </manufacturedMaterial>
979 </manufacturedProduct>
980 </consumable>
981 </substanceAdministration>
982 </entry>
983 </section>
984 </component>
985<!--
986******************************
987Results Section
988***********************
989-->
990<component>
991<section>
992<templateId root="2.16.840.1.113883.10.20.1.14"/>
993<code code="30954-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Relevant diagnostic tests and/or laboratory data"/>
994<title>Results</title>
995<text>
996<table border="1" width="100%">
997<tbody>
998<tr>
999<th>Test</th>
1000<th>Date</th>
1001<th>Result</th>
1002<th>Ref. Range</th>
1003
1004</tr>
1005
1006<tr>
1007<td>Calculated LDL</td>
1008<td>7-1-2010</td>
1009<td>LDL CHOLESTEROL 95 MG/DL</td>
1010<td>0-130</td>
1011
1012</tr>
1013<tr>
1014<td>HEMOGLOBIN A1C </td>
1015<td>7-1-2010</td>
1016<td>A1C 9.3 percent H</td>
1017<td>3.5-6.0</td>
1018</tr>
1019<tr>
1020<td>EJECTION FRACTION</td>
1021<td>20100207</td>
1022<td>38%</td>
1023<td>55-75</td>
1024</tr>
1025
1026</tbody>
1027</table>
1028</text>
1029
1030<entry contextConductionInd="true" typeCode="DRIV">
1031<organizer classCode="CLUSTER" moodCode="EVN">
1032<templateId root="2.16.840.1.113883.10.20.1.32"/>
1033<id root="38eb54f1-888c-11df-a4ee-0800200c9c66"/>
1034<code code="27571006" codeSystemName="LOINC" codeSystem="2.16.840.1.113883.6.1" displayName="chemistry"/>
1035<statusCode code="completed"/>
1036<effectiveTime value="201007011300"/>
1037
1038<!--LDL -->
1039<component>
1040<observation classCode="OBS" moodCode="EVN">
1041<templateId root="2.16.840.1.113883.3.88.11.83.15" assigningAuthorityName="HITSP C83"/>
1042<templateId root="2.16.840.1.113883.10.20.1.31" assigningAuthorityName="CCD"/>
1043<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC"/>
1044<!--WV GUID goes below-->
1045<id root="a32801b1-8855-11df-a4ee-0800200c9c66"/>
1046<code displayName="CALCULATED LDL IN MG/DL" code="13457-7" codeSystemName="LOINC" codeSystem="2.16.840.1.113883.6.1"/>
1047<!--WV Some other alternatives-->
1048<!--<code displayName="DIRECTLY MEASURED LDL IN MG/DL" code="18262-6" codeSystemName="LOINC" codeSystem="2.16.840.1.113883.6.1"/>-->
1049<!--<code displayName="LDL CHOLESTEROL, NO METHOD, MG/DL" code="2089-1" codeSystemName="LOINC" codeSystem="2.16.840.1.113883.6.1"/>-->
1050<statusCode code="completed"/>
1051<effectiveTime value="201007011300"/>
1052<value xsi:type="PQ" value="95" unit="MG/DL"/>
1053<referenceRange>
1054<observationRange>
1055<text>0-130</text>
1056</observationRange>
1057</referenceRange>
1058</observation>
1059</component>
1060</organizer>
1061</entry>
1062
1063<!--
1064********************************
1065Hemoglobin A1C in Hematology
1066***********************************
1067-->
1068<entry typeCode="DRIV">
1069<organizer classCode="CLUSTER" moodCode="EVN">
1070<templateId root="2.16.840.1.113883.10.20.1.32"/>
1071<id root="38eb54f7-888c-11df-a4ee-0800200c9c66"/>
1072<code code="272275004" codeSystemName="LOINC" codeSystem="2.16.840.1.113883.6.1" displayName="hematology"/>
1073<statusCode code="completed"/>
1074<effectiveTime value="201007011300"/>
1075
1076<component>
1077<observation classCode="OBS" moodCode="EVN">
1078<!--<templateId root="2.16.840.1.113883.3.88.11.83.15" assigningAuthorityName="HITSP C83"/>-->
1079<templateId root="2.16.840.1.113883.10.20.1.31" assigningAuthorityName="CCD"/>
1080<!--<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC"/>-->
1081<id root="a32801b6-8855-11df-a4ee-0800200c9c66"/>
1082<code displayName="HEMOGLOBIN A1C By UNKNOWN METHOD" code="4548-4" codeSystemName="LOINC" codeSystem="2.16.840.1.113883.6.1"/>
1083<statusCode code="completed"/>
1084<effectiveTime value="201007011300"/>
1085<value xsi:type="PQ" value="9.3" unit="%"/>
1086<interpretationCode displayName="Abnormal High" code="H" codeSystemName="2.16.840.1.113883.5.83"/>
1087<referenceRange>
1088<observationRange>
1089<text>3.5-6.0</text>
1090</observationRange>
1091</referenceRange>
1092</observation>
1093</component>
1094</organizer>
1095</entry>
1096
1097
1098<!--
1099******************************
1100ejection fraction
1101*******************************
1102THIS IS WHERE THE PROBLEM IS WITH STATUS
1103cvc-complex-type.2.4.a: Invalid content was found starting with element 'observation'. One of '{"urn:hl7-org:v3":statusCode}' is expected.
1104-->
1105
1106<entry contextConductionInd="true" typeCode="DRIV">
1107<organizer classCode="CLUSTER" moodCode="EVN">
1108<templateId root="2.16.840.1.113883.10.20.1.32"/>
1109<id root="38eb54f1-888c-11df-a4ee-0800200c9c66"/>
1110<code code="363679005" codeSystemName="SNM" displayName="IMAGING"/>
1111<statusCode code="completed"/>
1112<effectiveTime value="201002071300"/>
1113<component>
1114<observation classCode="OBS" moodCode="EVN">
1115<!--<templateId root="2.16.840.1.113883.3.88.11.83.15" assigningAuthorityName="HITSP C83"/>-->
1116<templateId root="2.16.840.1.113883.10.20.1.31" assigningAuthorityName="CCD"/>
1117<!--<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC"/>-->
1118<id root="38eb54f2-888c-11df-a4ee-0800200c9c66"/>
1119<code code="250908004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNM" displayName="LEFT VERTRICULAR EJECTION FRACTION"/>
1120<text>LEFT VERTRICULAR EJECTION FRACTION</text>
1121<statusCode code="completed"/>
1122<effectiveTime value="201002071300"/>
1123<value xsi:type="PQ" value="38" unit="%"/>
1124<referenceRange>
1125<observationRange>
1126<text>55-75</text>
1127</observationRange>
1128</referenceRange>
1129</observation>
1130</component>
1131</organizer>
1132</entry>
1133
1134</section>
1135</component>
1136<!--
1137******************************
1138Procedures Section
1139**********************
1140-->
1141<component>
1142<section>
1143<templateId root="2.16.840.1.113883.10.20.1.12"/>
1144<code code="47519-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="History of procedures"/>
1145<title>Procedures</title>
1146<text>
1147<table border="1" width="100%">
1148<tbody>
1149<tr>
1150<th>Procedure</th>
1151<th>Date </th>
1152<th>Ordered By</th>
1153<th>Performed By</th>
1154</tr>
1155<tr>
1156<td>Mammogram</td>
1157<td>2-07-2010</td>
1158<td>Nancy Anthracite, MD</td>
1159<td>Grover, Christie &amp; Merritt</td>
1160</tr>
1161<tr>
1162<td>Colonoscopy</td>
1163<td>3-17-2010</td>
1164<td>Nancy Anthracite, MD</td>
1165<td>John Gallager, MD</td>
1166</tr>
1167</tbody>
1168</table>
1169</text>
1170
1171<!--There are three options to choose from here those being Acts, Observations
1172or Procedures. Uncomment the one you need. These are in Tab M of the Downloadable Resource-->
1173<!--<entry typeCode="DRIV"/>
1174<procedure classCode="PROC" moodCode="EVN/>"
1175<templateId root="2.16.840.1.113883.10.20.1.29"/>-->
1176<!-- this is a purpose type of activity and a problem is a Problem Activity with a different template-->
1177<!--<act classCode="ACT" moodCode="EVN">
1178<templateId root="2.16.840.1.113883.10.20.1.30"/>-->
1179<!--There are lots of observation templates as well. This is the Result observation which I hope is right-->
1180<!--<observation classCode="OBS" moodCode="EVN">
1181<templateId root="2.16.840.1.113883.10.20.1.31"/>-->
1182
1183<entry typeCode="DRIV">
1184<procedure classCode="PROC" moodCode="EVN">
1185<templateId root="2.16.840.1.113883.10.20.1.29"/>
1186<id root="a32801b9-8855-11df-a4ee-0800200c9c66"/>
1187<code code="24623002" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNM" displayName="SCREENING MAMMOGRAPHY"/>
1188<statusCode code="completed"/>
1189<effectiveTime value="20100207"/>
1190<participant typeCode="DEV">
1191<participantRole classCode="MANU">
1192<templateId root="2.16.840.1.113883.10.20.1.52"/>
1193<id root="7eedbc62-8a15-11df-a4ee-0800200c9c66"/>
1194</participantRole>
1195</participant>
1196</procedure>
1197
1198
1199
1200
1201</entry>
1202</section>
1203 </component>
1204
1205
1206
1207 <!--
1208 *********************************************
1209 Immunization Section
1210 ***********************************************
1211 -->
1212 <component>
1213 <section>
1214 <templateId root="2.16.840.1.113883.10.20.1.6"/>
1215 <code code="11369-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="History of immunizations"/>
1216 <title>History of Immunizations</title>
1217 <text>
1218 <table border="1" width="100%">
1219 <thead>
1220 <tr>
1221 <th>Vaccine</th>
1222 <th>Date</th>
1223 <th>Status</th>
1224 </tr>
1225 </thead>
1226 <tbody>
1227 <tr>
1228 <td>Influenza virus vaccine, split</td>
1229 <td>Nov 2 2009</td>
1230 <td>Completed</td>
1231 </tr>
1232 <tr>
1233 <td>Pneumococcal vaccine</td>
1234 <td>Feb 7,2010</td>
1235 <td>Completed</td>
1236 </tr>
1237 </tbody>
1238 </table>
1239 </text>
1240 <entry typeCode="DRIV">
1241 <substanceAdministration classCode="SBADM" moodCode="EVN">
1242 <templateId root="2.16.840.1.113883.10.20.1.24"/>
1243 <!-- WVP Medication activity template -->
1244 <id root="2.16.840.1.113883.3.543" extension="01.02.03.100025"/>
1245
1246 <statusCode code="completed"/>
1247 <effectiveTime xsi:type="IVL_TS">
1248 <center value="20091015"/>
1249 </effectiveTime>
1250 <routeCode code="IM" codeSystem="2.16.840.1.113883.5.112" codeSystemName="RouteOfAdministration" displayName="Intramuscular injection"/>
1251 <consumable>
1252 <manufacturedProduct>
1253 <templateId root="2.16.840.1.113883.10.20.1.53"/>
1254 <!-- Product template -->
1255 <manufacturedMaterial>
1256 <!--Code is from table D Downloadabe Resource CVX code system is 6.59-->
1257 <code code="15" codeSystem="2.16.840.1.113883.6.59" displayName="INFLUENZA VIRUS VACCIINE, SPLIT">
1258 <originalText>INFLUENZA VIRUS VACCIINE, SPLIT</originalText>
1259 </code>
1260 </manufacturedMaterial>
1261 </manufacturedProduct>
1262 </consumable>
1263 </substanceAdministration>
1264 </entry>
1265 <entry typeCode="DRIV">
1266 <substanceAdministration classCode="SBADM" moodCode="EVN">
1267 <templateId root="2.16.840.1.113883.10.20.1.24"/>
1268 <!-- WVP Medication activity template -->
1269 <id root="2.16.840.1.113883.3.543" extension="01.02.03.100026"/>
1270
1271 <statusCode code="completed"/>
1272 <effectiveTime xsi:type="IVL_TS">
1273 <center value="20100110"/>
1274 </effectiveTime>
1275 <routeCode code="IM" codeSystem="2.16.840.1.113883.5.112" codeSystemName="RouteOfAdministration" displayName="Intramuscular injection"/>
1276 <consumable>
1277 <manufacturedProduct>
1278 <!-- WVP Product template -->
1279 <templateId root="2.16.840.1.113883.10.20.1.53"/>
1280 <manufacturedMaterial>
1281 <!--Code is from table D Downloadabe Resource CVX code system is 6.59-->
1282 <code code="33" codeSystem="2.16.840.1.113883.6.59" displayName="PNEUMOCCAL VACCINE">
1283 <originalText>PNEUMOCCAL VACCINE</originalText>
1284 </code>
1285 </manufacturedMaterial>
1286 </manufacturedProduct>
1287 </consumable>
1288 </substanceAdministration>
1289 </entry>
1290 </section>
1291 </component>
1292 <!--
1293*****************************************************
1294Vital Signs Section
1295****************************************
1296-->
1297<component>
1298<section>
1299<templateId root="2.16.840.1.113883.10.20.1.16"/>
1300<code code="8716-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Vital signs"/>
1301<title>Vital Signs</title>
1302<text>
1303<table border="1" width="100%">
1304<tbody>
1305<tr>
1306<th>Date</th>
1307<th>Vital Sign</th>
1308<th>Result</th>
1309<th>Source</th>
1310</tr>
1311<tr>
1312<td>2-10-2010</td>
1313<td>Systolic Blood Pressure</td>
1314<td>115</td>
1315<td>WorldVistA Test Clinic</td>
1316
1317</tr>
1318<tr>
1319<td>2-10-2010</td>
1320<td>Diastolic Blood Pressure</td>
1321<td>78</td>
1322<td>WorldVistA Test Clinic</td>
1323</tr>
1324<tr>
1325<td>2-10-2010</td>
1326<td>Heart Rate</td>
1327<td>64</td>
1328<td>WorldVistA Test Clinic</td>
1329</tr>
1330<tr>
1331<td>7-1-2010</td>
1332<td>Systolic Blood Pressure</td>
1333<td>117</td>
1334<td>WorldVistA Test Clinic</td>
1335
1336</tr>
1337<tr>
1338<td>7-1-2010</td>
1339<td>Diastolic Blood Pressure</td>
1340<td>79</td>
1341<td>WorldVistA Test Clinic</td>
1342</tr>
1343<tr>
1344<td>7-1-2010</td>
1345<td>Heart Rate</td>
1346<td>67</td>
1347<td>WorldVistA Test Clinic</td>
1348</tr>
1349</tbody>
1350</table>
1351</text>
1352
1353
1354<!--Vital Signs from 2-10-2010 under an organizer follow. Only these 3 vital signs are allowed-->
1355<!--WVV Must change the UUIDs for the vital signs and the entries-->
1356
1357<entry typeCode="DRIV">
1358<organizer classCode="CLUSTER" moodCode="EVN">
1359<templateId root="2.16.840.1.113883.10.20.1.32" assigningAuthorityName="CCD"/>
1360<templateId root="2.16.840.1.113883.10.20.1.35" assigningAuthorityName="CCD"/>
1361<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13.1" assigningAuthorityName="IHE PCC"/>
1362<id root="7eedbc60-8a15-11df-a4ee-0800200c9c66"/>
1363<code code="46680005" codeSystem="2.16.840.1.113883.6.96" displayName="Vital signs" codeSystemName="SNM"/>
1364<statusCode code="completed"/>
1365<effectiveTime value="20100210"/>
1366<component>
1367<observation classCode="OBS" moodCode="EVN">
1368<templateId root="2.16.840.1.113883.3.88.11.83.15" assigningAuthorityName="HITSP C83"/>
1369<templateId root="2.16.840.1.113883.10.20.1.31" assigningAuthorityName="CCD"/>
1370<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC"/>
1371<id root="a32801b7-8855-11df-a4ee-0800200c9c66"/>
1372<code displayName="SYSTOLIC BLOOD PRESSURE" code="72313002" codeSystemName="SNM" codeSystem="2.16.840.1.113883.6.96"/>
1373<statusCode code="completed"/>
1374<effectiveTime value="20100210"/>
1375<value xsi:type="PQ" value="115" unit="MM/HG"/>
1376</observation>
1377</component>
1378
1379<component>
1380<observation classCode="OBS" moodCode="EVN">
1381<templateId root="2.16.840.1.113883.3.88.11.83.15" assigningAuthorityName="HITSP C83"/>
1382<templateId root="2.16.840.1.113883.10.20.1.31" assigningAuthorityName="CCD"/>
1383<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC"/>
1384<id root="a32801b8-8855-11df-a4ee-0800200c9c66"/>
1385<code displayName="DIASTOLIC BLOOD PRESSURE" code="271649006" codeSystemName="SNM" codeSystem="2.16.840.1.113883.6.96"/>
1386<statusCode code="completed"/>
1387<effectiveTime value="20100210"/>
1388<value xsi:type="PQ" value="78" unit="MM/HG"/>
1389</observation>
1390</component>
1391
1392<component>
1393<observation classCode="OBS" moodCode="EVN">
1394<templateId root="2.16.840.1.113883.3.88.11.83.15" assigningAuthorityName="HITSP C83"/>
1395<templateId root="2.16.840.1.113883.10.20.1.31" assigningAuthorityName="CCD"/>
1396<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC"/>
1397<id root="7eedbc64-8a15-11df-a4ee-0800200c9c66"/>
1398<code displayName="HEART RATE" code="364075005" codeSystemName="SNM" codeSystem="2.16.840.1.113883.6.96"/>
1399<statusCode code="completed"/>
1400<effectiveTime value="20100210"/>
1401<value xsi:type="PQ" value="64" unit="/min"/>
1402</observation>
1403</component>
1404</organizer>
1405</entry>
1406
1407<!--Vital Signs from 7-1-2010 under an organizer follow. Onlty these 3 vistal signs are allowed-->
1408<!--WVV Must change the UUIDs for the vital signs and the entries-->
1409
1410<entry typeCode="DRIV">
1411<organizer classCode="CLUSTER" moodCode="EVN">
1412<templateId root="2.16.840.1.113883.10.20.1.32" assigningAuthorityName="CCD"/>
1413<templateId root="2.16.840.1.113883.10.20.1.35" assigningAuthorityName="CCD"/>
1414<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13.1" assigningAuthorityName="IHE PCC"/>
1415<id root="7eede370-8a15-11df-a4ee-0800200c9c66"/>
1416<code code="46680005" codeSystem="2.16.840.1.113883.6.96" displayName="Vital signs" codeSystemName="SNM"/>
1417<statusCode code="completed"/>
1418<effectiveTime value="20100701"/>
1419<component>
1420<observation classCode="OBS" moodCode="EVN">
1421<templateId root="2.16.840.1.113883.3.88.11.83.15" assigningAuthorityName="HITSP C83"/>
1422<templateId root="2.16.840.1.113883.10.20.1.31" assigningAuthorityName="CCD"/>
1423<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC"/>
1424<id root="7eede371-8a15-11df-a4ee-0800200c9c66"/>
1425<code displayName="SYSTOLIC BLOOD PRESSURE" code="72313002" codeSystemName="SNM" codeSystem="2.16.840.1.113883.6.96"/>
1426<statusCode code="completed"/>
1427<effectiveTime value="20100701"/>
1428<value xsi:type="PQ" value="117" unit="MM/HG"/>
1429</observation>
1430</component>
1431
1432<component>
1433<observation classCode="OBS" moodCode="EVN">
1434<templateId root="2.16.840.1.113883.3.88.11.83.15" assigningAuthorityName="HITSP C83"/>
1435<templateId root="2.16.840.1.113883.10.20.1.31" assigningAuthorityName="CCD"/>
1436<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC"/>
1437<id root="7eede372-8a15-11df-a4ee-0800200c9c66"/>
1438<code displayName="DIASTOLIC BLOOD PRESSURE" code="271649006" codeSystemName="SNM" codeSystem="2.16.840.1.113883.6.96"/>
1439<statusCode code="completed"/>
1440<effectiveTime value="20100701"/>
1441<value xsi:type="PQ" value="78" unit="MM/HG"/>
1442</observation>
1443</component>
1444
1445<component>
1446<observation classCode="OBS" moodCode="EVN">
1447<templateId root="2.16.840.1.113883.3.88.11.83.15" assigningAuthorityName="HITSP C83"/>
1448<templateId root="2.16.840.1.113883.10.20.1.31" assigningAuthorityName="CCD"/>
1449<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC"/>
1450<id root="7eede373-8a15-11df-a4ee-0800200c9c66"/>
1451<code displayName="HEART RATE" code="364075005" codeSystemName="SNM" codeSystem="2.16.840.1.113883.6.96"/>
1452<statusCode code="completed"/>
1453<effectiveTime value="20100701"/>
1454<value xsi:type="PQ" value="67" unit="/min"/>
1455</observation>
1456</component>
1457
1458</organizer>
1459</entry>
1460</section>
1461</component>
1462
1463 <!--
1464************************
1465Structured Data Section
1466*************************
1467-->
1468
1469<component>
1470<section>
1471<!--Template ID is in the downloadable resource bottom of S tab -->
1472<templateId root="2.16.840.1.113883.3.249.11.16"/>
1473<code code="STRUCT" codeSystem="2.16.840.1.113883.3.249.12"/>
1474<title> Structured data section </title>
1475<text>
1476<table border="1" width="100%">
1477<tbody>
1478<tr>
1479<td>Certified System Used</td>
1480<td>System Type</td>
1481<td>Certification Type</td>
1482<td>Encounter Date Used</td>
1483</tr>
1484<tr>
1485<td>WorldVistA EHR</td>
1486<td> EHR</td>
1487<td>CCHIT Certified</td>
1488<td>2-10-2010</td>
1489</tr>
1490<tr>
1491<td>WorldVistA EHR</td>
1492<td>EHR</td>
1493<td>Qualified System</td>
1494<td>7-1-2010</td>
1495</tr>
1496<tr>
1497<td>Allscripts</td>
1498<td>eRx</td>
1499<td>Qualified</td>
1500<td>7-1-2010</td>
1501</tr>
1502</tbody>
1503</table>
1504</text>
1505<entry>
1506<act classCode="ACT" moodCode="EVN">
1507<templateId root="2.16.840.1.113883.3.249.11.13"/>
1508<id root="2.16.840.1.113883.3.543" extension="0.01.02.100000001.1"/>
1509<!--WV? this is in downloadable resource R and is the same for eRx and EHR-->
1510<!--WV? The G code changes and that is in tab R for 2010 as well-->
1511<!--There need to be two face to face encounters so this is one and the next one is one-->
1512<!--Also reflected in the documentationOf part at the end of the header-->
1513<code code="G8447" codeSystem="2.16.840.1.113883.6.14" displayName="Patient encounter was documented using a CCHIT certified EHR"/>
1514<effectiveTime value="20100210"/>
1515</act>
1516</entry>
1517<entry>
1518<act classCode="ACT" moodCode="EVN">
1519<templateId root="2.16.840.1.113883.3.249.11.13"/>
1520<id root="2.16.840.1.113883.3.543" extension="0.01.02.100000001.2"/>
1521<code code="G8448" codeSystem="2.16.840.1.113883.6.14" displayName="Patient encounter was documented using a Qualified (Non-CCHIT certified) EHR"/>
1522<effectiveTime value="20100701"/>
1523</act>
1524</entry>
1525<entry>
1526<act classCode="ACT" moodCode="EVN">
1527<templateId root="2.16.840.1.113883.3.249.11.14"/>
1528<id root="2.16.840.1.113883.19.5" extension="96756615"/>
1529<code code="G8553" codeSystem="2.16.840.1.113883.6.14" displayName="Electronic prescription has been generated using a qualified eRx system"/>
1530<effectiveTime value="20100701"/>
1531</act>
1532</entry>
1533</section>
1534</component>
1535
1536
1537
1538 <component>
1539 <section>
1540 <templateId root="2.16.840.1.113883.10.20.1.1"/>
1541 <code code="42348-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Advance directives"/>
1542 <title/>
1543 </section>
1544 </component>
1545<!--
1546 ************************************
1547 Payers section
1548
1549 *******************************
1550 -->
1551
1552<component>
1553<section>
1554<templateId root="2.16.840.1.113883.10.20.1.9"/>
1555<!-- 48768-6 is payment sources -->
1556<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
1557<title>Payment Sources</title>
1558<text>
1559<table border="1" width="100%">
1560<tbody>
1561<tr>
1562<th>Payer name</th>
1563<th>Group/Type</th>
1564<th>Primary Policy Owner/Responsible Party</th>
1565<th>Covered party ID</th>
1566<th>Payor Telephone</th>
1567<th>Electronic Claims Payor Number</th>
1568<th>Authorized</th>
1569</tr>
1570<tr>
1571<td>Mail Handlers Benefit Plan</td>
1572<td>454</td>
1573<td>Jody Jean Jones</td>
1574<td>8888888</td>
1575<td>1-800-410-7778</td>
1576<td>62413</td>
1577<td>Colonoscopy</td>
1578</tr>
1579</tbody>
1580</table>
1581</text>
1582<!--WVP - DRIV is derived from-->
1583<entry typeCode="DRIV">
1584<!--WVP moodCode is DEF is definition to describe the characteristics of who must be involved in an act-->
1585<act classCode="ACT" moodCode="DEF">
1586<!--WVP coverage activity templats is the 10.20.1.20-->
1587<templateId root="2.16.840.1.113883.10.20.1.20"/>
1588<id root="d5dc6d50-890c-11df-a4ee-0800200c9c66"/>
1589<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" displayName="Payment sources"/>
1590<statusCode code="completed"/>
1591<!--WVP COMP is has component like a sub service to this service-->
1592<entryRelationship typeCode="COMP">
1593<!-- WVP EVN for the act is event-->
1594<act classCode="ACT" moodCode="EVN">
1595<!--Policy activity is the 10.20.1.26 template-->
1596<templateId root="2.16.840.1.113883.10.20.1.26"/>
1597<!-- another random GUID-->
1598<id root="d5dc6d51-890c-11df-a4ee-0800200c9c66"/>
1599<!--WV variable and display name is in quotes AUTOPOL - "automobile" policy;EHCPOL additional insurance in addition to Medicare in this case-->
1600<!--HSAPOL "Health Spending Account";PUBLICPOL "public healthcare" but not Medicare - maybe a state program for example-->
1601<!--WBCPOL is "workers compensation"-->
1602<code code="EHCPOL" codeSystem="2.16.840.1.113883.5.4" displayName="Extended healthcare"/>
1603<!--other statusCode normal, aborted, active, cancelled, completed, held, suspended, nullified, obsolete-->
1604<statusCode code="completed"/>
1605<!--WVP performer type codes are numerous but PRF is performer or the person who did it-->
1606<performer typeCode="PRF">
1607<assignedEntity>
1608<!--Not another GUID??-->
1609<id root="2.16.840.1.113883.12.86" extension="PI"/>
1610<representedOrganization>
1611<name>Mail Handler Benefit Plan</name>
1612</representedOrganization>
1613</assignedEntity>
1614</performer>
1615<participant typeCode="COV">
1616<participantRole>
1617<!--Cant find SELF in the reference documents so this might be variable, but I doubt it is-->
1618<!-- I suspect this is shat is used whenever the person is the primary policy holder-->
1619<!-- service deliver location role type is what the 5.111 code is and it is called a "RoleCode" in the downloadable resource-->
1620<!-- in this case theextension is the patients SSN for a medicare patient-->
1621<id root="2.16.840.1.113883.4.1" extension="002030004"/>
1622<code code="SELF" codeSystem="2.16.840.1.113883.5.111" displayName="Self"/>
1623</participantRole>
1624</participant>
1625<!--WVP REFR is "refers to" target act is refered to by the source act-->
1626<entryRelationship typeCode="REFR">
1627<act classCode="ACT" moodCode="EVN">
1628<!--Authorization activity Template-->
1629<templateId root="2.16.840.1.113883.10.20.1.19"/>
1630<id root="2.16.840.1.113883.19.5.10" extension="100010"/>
1631<code nullFlavor="NA"/>
1632<!--WVP SUBJ is "has subject"-->
1633<entryRelationship typeCode="SUBJ">
1634<!--PROC is "procedure" and PRMS is "promise"-->
1635<procedure classCode="PROC" moodCode="PRMS">
1636<!--SNOMED code for colonoscopy-->
1637<code code="73761001" codeSystem="2.16.840.1.113883.6.96" displayName="Colonoscopy"/>
1638</procedure>
1639</entryRelationship>
1640</act>
1641</entryRelationship>
1642</act>
1643</entryRelationship>
1644</act>
1645</entry>
1646
1647<!--medicare-->
1648<entry typeCode="DRIV">
1649<!--WVP moodCode is DEF is definition to describe the characteristics of who must be involved in an act-->
1650<act classCode="ACT" moodCode="DEF">
1651<!--WVP coverage activity templats is the 10.20.1.20-->
1652<templateId root="2.16.840.1.113883.10.20.1.20"/>
1653<id root="1751b180-8a54-11df-a4ee-0800200c9c66"/>
1654<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" displayName="Payment sources"/>
1655<statusCode code="completed"/>
1656<!--WVP COMP is has component like a sub service to this service-->
1657<entryRelationship typeCode="COMP">
1658<!-- WVP EVN for the act is event-->
1659<act classCode="ACT" moodCode="EVN">
1660<!--Policy activity is the 10.20.1.26 template-->
1661<templateId root="2.16.840.1.113883.10.20.1.26"/>
1662<!-- another random GUID-->
1663<id root="dbbb6311-8a4d-11df-a4ee-0800200c9c66"/>
1664<!--WV variable and display name is in quotes AUTOPOL - "automobile" policy;EHCPOL additional insurance in addition to Medicare in this case-->
1665<!--HSAPOL "Health Spending Account";PUBLICPOL "public healthcare" but not Medicare - maybe a state program for example-->
1666<!--WBCPOL is "workers compensation"-->
1667<code code="PUBLICPOL" codeSystem="2.16.840.1.113883.5.4" displayName="Public Healthcare"/>
1668<!--other statusCode normal, aborted, active, cancelled, completed, held, suspended, nullified, obsolete-->
1669<statusCode code="completed"/>
1670<!--WVP performer type codes are numerous but PRF is performer or the person who did it-->
1671<performer typeCode="PRF">
1672<assignedEntity>
1673<!--another GUID??-->
1674<id root="2.16.840.1.113883.12.86" extension="MC"/>
1675<representedOrganization>
1676<name>CMS</name>
1677</representedOrganization>
1678</assignedEntity>
1679</performer>
1680<participant typeCode="COV">
1681<participantRole>
1682<!--Cant find SELF in the reference documents so this might be variable, but I doubt it is-->
1683<!-- I suspect this is shat is used whenever the person is the primary policy holder-->
1684<!-- service deliver location role type is what the 5.111 code is and it is called a "RoleCode" in the downloadable resource-->
1685<id root="1751b180-8a54-11df-a4ee-0800200c9c66"/>
1686<!-- in this case theextension is the patients SSN for a medicare patient so it is the same each time for one patient-->
1687<id root="2.16.840.1.113883.4.1" extension="002030399"/>
1688<code code="SELF" codeSystem="2.16.840.1.113883.5.111" displayName="Self"/>
1689</participantRole>
1690</participant>
1691<!--WVP REFR is "refers to" target act is refered to by the source act-->
1692<entryRelationship typeCode="REFR">
1693<act classCode="ACT" moodCode="EVN">
1694<!--Authorization activity Template-->
1695<templateId root="2.16.840.1.113883.10.20.1.19"/>
1696<id root="e1e0f7e0-8a53-11df-a4ee-0800200c9c66"/>
1697<code nullFlavor="NA"/>
1698<!--WVP SUBJ is "has subject"-->
1699<entryRelationship typeCode="SUBJ">
1700<!--PROC is "procedure" and PRMS is "promise"-->
1701<procedure classCode="PROC" moodCode="PRMS">
1702<!--SNOMED code for colonoscopy-->
1703<code code="73761001" codeSystem="2.16.840.1.113883.6.96" displayName="Colonoscopy"/>
1704</procedure>
1705</entryRelationship>
1706</act>
1707</entryRelationship>
1708</act>
1709</entryRelationship>
1710
1711
1712</act>
1713</entry>
1714</section>
1715</component>
1716</section>
1717</component>
1718</section>
1719</component>
1720</structuredBody>
1721</component>
1722</ClinicalDocument>
1723
1724
1725
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