421 lines
15 KiB
XML
421 lines
15 KiB
XML
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<?xml version="1.0" encoding="utf-8"?>
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<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">
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<id root="eb60a84e-ae24-4f77-a649-ccfeb10a373f"/>
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<code code="55182-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Quality Measure Report"/>
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<title>QRDA Incidence Report</title>
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<postalCode/>
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</addr>
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<telecom/>
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<patient>
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<name>
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<given>MALE-A</given>
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<providerOrganization>
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<!-- NPI for the provider-->
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<id root="2.16.840.1.113883.4.6" extension="1558574525" />
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<name>WorldVistA Test Clinic</name>
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<!--WVV Address of organization is optional except for the STATE-->
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<addr>
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<state>MD</state>
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<postalCode>20877</postalCode>
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</addr>
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<!--WVP required asOrganizationPartOf added to sample-->
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<asOrganizationPartOf>
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<wholeOrganization>
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<!-- Tax ID is the extension-->
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<given>Nancy</given>
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<suffix>MD</suffix>
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</name>
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<id root="2.16.840.1.113883.3.543" extension="1558574526"/>
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<name>WorldVistA Test Clinic</name>
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<id root="2.16.840.1.113883.3.543" extension="1558574526"/>
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<name>World VistA Test Clinic</name>
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<name>WorldVistA Test Clinic</name>
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<name>
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<given>Nancy</given>
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<family>Anthracite</family>
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<suffix>MD</suffix>
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</name>
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</assignedPerson>
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<representedOrganization>
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<id root="2.16.840.1.113883.3.543" extension="1558574526"/>
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<name>WorldVistA Test Clinic</name>
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</representedOrganization>
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</assignedEntity>
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</legalAuthenticator>
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<participant typeCode="PRF">
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<name>
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<prefix>Dr.</prefix>
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<given>Nancy</given>
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<family>Anthracite</family>
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</name>
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<documentationOf>
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<serviceEvent>
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<code displayName="COMPREHENSIVE (45min)" code="99204" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
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<effectiveTime>
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<low value="20101013"/>
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<high value="20101013"/>
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</effectiveTime>
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<performer typeCode="PRF">
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<code code="62247001" codeSystem="2.16.840.1.113883.6.69" codeSystemName="SNM CT" displayName="Internal Medician Specialist"/>
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<addr>
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<streetAddressLine>123 Maple Ave</streetAddressLine>
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<city>Gaithersburg</city>
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<state>MD</state>
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<postalCode>20877</postalCode>
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</addr>
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<assignedPerson>
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<name>
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<given>Nancy</given>
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<family>Anthracite</family>
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<suffix>MD</suffix>
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</name>
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<documentationOf>
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<serviceEvent>
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<effectiveTime>
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<low value="20101014"/>
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<high value="20101014"/>
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<addr>
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<streetAddressLine>123 Maple Ave</streetAddressLine>
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<city>Gaithersburg</city>
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<state>MD</state>
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<postalCode>20877</postalCode>
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</addr>
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<assignedPerson>
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<name>
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<given>Nancy</given>
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<family>Anthracite</family>
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<suffix>MD</suffix>
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</name>
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</assignedPerson>
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<component>
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<section>
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<code code="55185-3" codeSystem="2.16.840.1.113883.6.1"/>
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<title>Measure set: CMS EHR Measure Set</title>
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<text>2010 Measures Set Measures</text>
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<component>
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<section>
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<templateId root="2.16.840.1.113883.3.249.11.60"/>
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<code code="55186-1" codeSystem="2.16.840.1.113883.6.1"/>
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<title>Measure Section</title>
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<text>
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<list>
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<item>CMS Measure #1: Diabetes Mellitus: Hemoglobin A1c Poor Control in Diabetes Mellitus</item>
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<item>CMS Measure #2: Diabetes Mellitus: Low Density Lipoprotein (LDL-C) Control in Diabetes Mellitus</item>
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<item>CMS Measure #3: Diabetes Mellitus: High Blood Pressure Control in Diabetes Mellitus</item>
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<item>CMS Measure #5: Heart Failure: Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)</item>
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<item>CMS Measure #7: Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI)</item>
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<item>CMS Measure #110: Preventive Care and Screening: Influenza Immunization for Patients >= 50 Years</item>
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<item>CMS Measure #111: Preventive Care and Screening: Pneumonia Vaccination for Patients 65 Years and Older</item>
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<item>CMS Measure #112: Preventive Care and Screening: Screening Mammography</item>
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<item>CMS Measure #113: Preventive Care and Screening: Colorectal Cancer Screening</item>
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<item>CMS Measure #124: Health Information Technology (HIT): Adoption/Use of Electronic Health Records (EHR)</item>
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<item>CMS Measure eRx:Adoption/Use of Medication Electronic Prescribing Measure</item>
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<item>CMS Measure #39: Screening or Therapy for Osteoporosis for Women Aged 65 Years and Older</item>
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<item>CMS Measure #47: Advance Care Plan </item>
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<item>CMS Measure #48: Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older</item>
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<item>CMS Measure #128: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up </item>
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<item>CMS Measure #173: Preventive Care and Screening: Unhealthy Alcohol Use - Screening</item>
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<item>CMS Measure #0013: Hypertension (HTN): Blood Pressure Measurement - QRDA Cat I template </item>
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<item>CMS Measure #0022: Drugs to be avoided in the Elderly </item>
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<item>CMS Measure #0024: Body Mass Index (BMI) 2 through 18 years of age </item>
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<item>CMS Measure #0028: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention</item>
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<item>CMS Measure #0038: Childhood Immunization Status - QRDA Cat I template</item>
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</list>
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</text>
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<entry typeCode="DRIV">
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<act classCode="ACT" moodCode="DEF">
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<code code="PQRI-1" codeSystem="2.16.840.1.113883.3.249.12" displayName="Hemoglobin A1c Poor Control in Diabetes Mellitus"/>
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<text>Percentage of patients 18 through 75 years with diabetes mellitus who had most recent hemoglobin A1C greater than 9.0%</text>
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<statusCode code="completed"/>
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</act>
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||
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<component>
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<section>
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<code code="55187-9" codeSystem="2.16.840.1.113883.6.1"/>
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<title>Reporting Parameters</title>
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<text>
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<list>
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<item>Reporting Period Jan 1, 2010 to Dec 31, 2010</item>
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</list>
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</text>
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||
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<low value="20100101"/>
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<high value="20101231"/>
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<section>
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||
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<code code="55188-7" codeSystem="2.16.840.1.113883.6.1"/>
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<title>Patient Data</title>
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<addr use="WP">
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||
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<streetAddressLine>VA MEDICAL CENTER</streetAddressLine>
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||
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<city>ALBANY</city>
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<state>NY</state>
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<postalCode>12180</postalCode>
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</addr>
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||
|
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<telecom/>
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||
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<assignedPerson>
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<name>
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<given>NANCY</given>
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<family>ANTHRACITE</family>
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|
</text>
|
||
|
|
<statusCode code="completed"/>
|
||
|
|
<effectiveTime>
|
||
|
|
<low value="20101014"/>
|
||
|
|
<high value="20101014"/>
|
||
|
|
</effectiveTime>
|
||
|
|
<value xsi:type="CD" displayName="Diabetes (ICD-9-CM 250.00)" code="250.00" codeSystemName="I9" codeSystem="2.16.840.1.113883.6.103"/>
|
||
|
|
<entryRelationship typeCode="REFR">
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||
|
|
<observation classCode="OBS" moodCode="EVN">
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||
|
|
<templateId root="2.16.840.1.113883.10.20.1.50"/>
|
||
|
|
<code code="33999-4" codeSystem="2.16.840.1.113883.6.1" displayName="Status"/>
|
||
|
|
<statusCode code="completed"/>
|
||
|
|
<value xsi:type="CD" code="55561003" codeSystem="2.16.840.1.113883.6.96" displayName="Active" codeSystemName="SNM">
|
||
|
|
<originalText>Active</originalText>
|
||
|
|
</value>
|
||
|
|
</observation>
|
||
|
|
</entryRelationship>
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||
|
|
</observation>
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||
|
|
</entryRelationship>
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||
|
|
</act>
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||
|
|
</entry>
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||
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|
<entry typeCode="DRIV">
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||
|
|
<act classCode="ACT" moodCode="EVN">
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||
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|
<templateId root="2.16.840.1.113883.10.20.1.27"/>
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||
|
|
<id root="PROBLEM2" extension="CCRObjectID"/>
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||
|
|
<code nullFlavor="NA"/>
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||
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|
<performer typeCode="PRF">
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||
|
|
<assignedEntity>
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||
|
|
<id extension="ACTORPROVIDER_10000000020" root="CCRActorID"/>
|
||
|
|
<addr use="WP">
|
||
|
|
<streetAddressLine>VA MEDICAL CENTER</streetAddressLine>
|
||
|
|
<city>ALBANY</city>
|
||
|
|
<state>NY</state>
|
||
|
|
<postalCode>12180</postalCode>
|
||
|
|
</addr>
|
||
|
|
<telecom/>
|
||
|
|
<assignedPerson>
|
||
|
|
<name>
|
||
|
|
<given>NANCY</given>
|
||
|
|
<family>ANTHRACITE</family>
|
||
|
|
</name>
|
||
|
|
</assignedPerson>
|
||
|
|
</assignedEntity>
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||
|
|
</performer>
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||
|
|
<entryRelationship typeCode="SUBJ">
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||
|
|
<observation classCode="OBS" moodCode="EVN">
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||
|
|
<templateId root="2.16.840.1.113883.10.20.1.28" assigningAuthorityName="CCD"/>
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||
|
|
<id root="PROBLEM2" extension="CCRObjectID"/>
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||
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|
<code code="55607006" displayName="Problem" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNM"/>
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||
|
|
<text>
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||
|
|
<reference value="#PROBLEM2"/>
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||
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|
</text>
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||
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|
<statusCode code="completed"/>
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||
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|
<effectiveTime>
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||
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|
<low value="20101013"/>
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||
|
|
<high value="20101013"/>
|
||
|
|
</effectiveTime>
|
||
|
|
<value xsi:type="CD" displayName="Nonproliferative Diabetic retinopathy NOS (ICD-9-CM 362.03)" code="362.03" codeSystemName="I9" codeSystem="2.16.840.1.113883.6.103"/>
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||
|
|
<entryRelationship typeCode="REFR">
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<observation classCode="OBS" moodCode="EVN">
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||
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|
<templateId root="2.16.840.1.113883.10.20.1.50"/>
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||
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|
<code code="33999-4" codeSystem="2.16.840.1.113883.6.1" displayName="Status"/>
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||
|
|
<statusCode code="completed"/>
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||
|
|
<value xsi:type="CD" code="55561003" codeSystem="2.16.840.1.113883.6.96" displayName="Active" codeSystemName="SNM">
|
||
|
|
<originalText>Active</originalText>
|
||
|
|
</value>
|
||
|
|
</observation>
|
||
|
|
</entryRelationship>
|
||
|
|
</observation>
|
||
|
|
</entryRelationship>
|
||
|
|
</act>
|
||
|
|
</entry>
|
||
|
|
</section>
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||
|
|
</component>
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||
|
|
<component>
|
||
|
|
<section>
|
||
|
|
<templateId root="2.16.840.1.113883.10.20.1.9"/>
|
||
|
|
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment Sources"/>
|
||
|
|
<title>Payers</title>
|
||
|
|
<entry typeCode="DRIV">
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||
|
|
<act classCode="ACT" moodCode="DEF">
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||
|
|
<templateId root="2.16.840.1.113883.10.20.1.20"/>
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||
|
|
<id root="1751b180-8a54-11df-a4ee-0800200c9c66"/>
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||
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|
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" displayName="Payment sources"/>
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||
|
|
<statusCode code="completed"/>
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||
|
|
<entryRelationship typeCode="COMP">
|
||
|
|
<act classCode="ACT" moodCode="EVN">
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||
|
|
<templateId root="2.16.840.1.113883.10.20.1.26"/>
|
||
|
|
<id root="dbbb6311-8a4d-11df-a4ee-0800200c9c66"/>
|
||
|
|
<code code="PUBLICPOL" codeSystem="2.16.840.1.113883.5.4" displayName="Public Healthcare"/>
|
||
|
|
<statusCode code="completed"/>
|
||
|
|
<performer typeCode="PRF">
|
||
|
|
<assignedEntity>
|
||
|
|
<id root="2.16.840.1.113883.12.86" extension="MC"/>
|
||
|
|
</assignedEntity>
|
||
|
|
</performer>
|
||
|
|
<participant typeCode="COV">
|
||
|
|
<participantRole>
|
||
|
|
<id root="2.16.840.1.113883.4.1" extension="345982321"/>
|
||
|
|
<code code="SELF" codeSystem="2.16.840.1.113883.5.111" displayName="Self"/>
|
||
|
|
</participantRole>
|
||
|
|
</participant>
|
||
|
|
</act>
|
||
|
|
</entryRelationship>
|
||
|
|
</act>
|
||
|
|
</entry>
|
||
|
|
</section>
|
||
|
|
</component>
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||
|
|
</section>
|
||
|
|
</component>
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||
|
|
</section>
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||
|
|
</component>
|
||
|
|
</structuredBody>
|
||
|
|
</component>
|
||
|
|
</ClinicalDocument>
|