723 lines
38 KiB
XML
723 lines
38 KiB
XML
<?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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<realmCode code="US"/>
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<typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040"/>
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<templateId root="2.16.840.1.113883.3.249.11.100.1"/>
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<id root="2.16.840.1.113883.3.543" extension="c9bec8aa-e5e7-11df-ba06-3b3edcef0468"/>
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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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<effectiveTime value="20100703"/>
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<patientRole>
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<id extension="002030004" root="2.16.840.1.113883.4.1"/>
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<addr use="H">
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<streetAddressLine/>
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<city/>
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<state/>
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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>JODY</given>
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<given>JEAN</given>
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<family>JONES</family>
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</name>
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<administrativeGenderCode displayName="FEMALE" code="F" codeSystemName="HL7 AdministrativeGender" codeSystem="2.16.840.1.113883.5.1"/>
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<birthTime value="19450101120000"/>
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</patient>
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<providerOrganization>
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<!-- NPI for the provider and this is a real number-->
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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 and this is a dummy numbers-->
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<id root="2.16.840.1.113883.4.2" extension="226864459"/>
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</wholeOrganization>
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</asOrganizationPartOf>
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</providerOrganization>
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</patientRole>
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</recordTarget>
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<author>
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<time value="20100703"/>
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<id root="2.16.840.1.113883.3.249.6" extension="100001"/>
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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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<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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</author>
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<informant>
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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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</informant>
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<custodian>
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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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</representedCustodianOrganization>
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<legalAuthenticator>
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<time value="20100703"/>
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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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<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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<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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</associatedPerson>
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</participant>
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<documentationOf>
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<code displayName="EXPANDED, HX & EXAM" code="99202" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
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<low value="20100828"/>
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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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<documentationOf>
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<serviceEvent>
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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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<code displayName="INTERMEDIATE (15min)" code="99213" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
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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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<code displayName="INTERMEDIATE (15min)" code="99213" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
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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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<code displayName="Office/Outpatient Visit of an Established Patient requiring (2 of 3) an Expanded History, an Exam and Medical Decision Making of Low Complexity (CPT-4 99213)" code="99213" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
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<effectiveTime>
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<low value="20100731"/>
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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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<documentationOf>
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<code displayName="EXTENDED (25min)" code="99214" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
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<low value="20101016"/>
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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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<city>Gaithersburg</city>
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<postalCode>20877</postalCode>
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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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<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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<documentationOf>
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<code displayName="Office/Outpatient Visit of an Established Patient requiring (2 of 3) a Detailed History, an Exam and Medical Decision Making of Moderate Complexity (CPT-4 99214)" code="99214" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
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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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<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="2.16.840.1.113883.3.249.11.2"/>
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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>
|
|
<item>CMS Measure #1: Diabetes Mellitus: Hemoglobin A1c Poor Control in Diabetes Mellitus</item>
|
|
</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>
|
|
<statusCode code="completed"/>
|
|
</act>
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|
</entry>
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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>
|
|
<text>
|
|
<list>
|
|
<item>Reporting Period Jan 1, 2010 to Dec 31, 2010</item>
|
|
</list>
|
|
</text>
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|
<entry>
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|
<act classCode="ACT" moodCode="EVN">
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<code code="252116004" codeSystem="2.16.840.1.113883.6.96" displayName="Observation Parameters"/>
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<effectiveTime>
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<low value="20100101"/>
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<section>
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<title>Patient Data</title>
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<code code="11450-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Problem list"/>
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<title>Problems</title>
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<text/>
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<act classCode="ACT" moodCode="EVN">
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