CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG
1.0.0 - Release 1

CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG - Downloaded Version 1.0.0 See the Directory of published versions

## Example Bundle: Example ACH Daily Submission Negative PCR Bundle

Profile: NHSN Subject Bundle

Bundle bundle-example-ach-daily-subject-negativepcr of type collection

Entry 1 - fullUrl = http://nhsnlink.org/fhir/MeasureReport/measurereport-example-ach-daily-negativepcr

Resource MeasureReport:

> Profile: DEQM Individual MeasureReport Profile

> DEQM Measure Scoring Extension: Cohort

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): ACHDaily NegativePCR(official) Other, DoB: 2005-02-01 ( MRN: 1000009001 (use: usual, ))

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#123456789986 (use: usual, ); status = finished; class = Observation Encounter (ActCode[9.0.0]#OBSENC); type = Hospital admission (procedure); period = 2024-01-01 08:00:00+0000 --> 2024-01-02 06:00:00+0000; reasonCode = shortness of breath

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#123456789986 (use: usual, ); status = finished; class = Inpatient Encounter (ActCode[9.0.0]#IMP); type = Hospital admission (procedure); period = 2024-01-02 06:01:00+0000 --> 2024-01-16 08:30:00+0000; reasonCode = shortness of breath

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Coverage: identifier = Member Number: 88800933501; status = active; type = subsidized health program; subscriberId = 123456789; relationship = Self; period = 2023-01-01 --> (ongoing)

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Condition COVID-19

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: status = completed; medication[x] = ->Molnupiravir 200 mg PO BID; effective[x] = 2024-01-02 09:00:00+0000 --> 2024-01-06 08:59:09+0000

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101903002 (use: usual, ); status = completed; intent = order; category = Inpatient; medication[x] = ->Molnupiravir 200 mg; authoredOn = 2024-01-02 21:30:15+0000; courseOfTherapyType = Short course (acute) therapy

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Observation SARS-CoV-2 (COVID-19) N gene [Presence] in Specimen by Nucleic acid amplification using CDC primer-probe set N1

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Observation SARS-CoV-2 (COVID-19) N gene [Presence] in Specimen by Nucleic acid amplification using CDC primer-probe set N1

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): ServiceRequest SARS-CoV-2 (COVID-19) N gene [Presence] in Specimen by Nucleic acid amplification using CDC primer-probe set N1

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): ServiceRequest SARS-CoV-2 (COVID-19) N gene [Presence] in Specimen by Nucleic acid amplification using CDC primer-probe set N1

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Specimen: type = Nasal fluid specimen (specimen); receivedTime = 2024-01-01 08:30:00+0000

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Specimen: type = Nasal fluid specimen (specimen); receivedTime = 2024-01-02 16:30:00+0000

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Procedure Intubation of respiratory tract (procedure)

> identifier: `http://example.org/fhir/measurereport/id`/123456789-pass1

> status: Complete

> type: Individual

> measure: NHSN Acute Care Hospital Daily Initial Populationversion: null1.0.0)

> subject: ACHDaily NegativePCR(official) Other, DoB: 2005-02-01 ( MRN: 1000009001 (use: usual, ))

> date: 2024-01-06 21:04:29+0000

> reporter: Organization Example NHSN Submitter

> period: 2024-01-05 00:00:00+0000 --> 2024-01-06 00:00:00+0000

> improvementNotation: Increased score indicates improvement

> > group

> > ### Populations

> > - | Code | Count
> > * | Initial Population | 1

> evaluatedResource:

> - ACHDaily NegativePCR(official) Other, DoB: 2005-02-01 ( MRN: 1000009001 (use: usual, ))
> - Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#123456789986 (use: usual, ); status = finished; class = Observation Encounter (ActCode[9.0.0]#OBSENC); type = Hospital admission (procedure); period = 2024-01-01 08:00:00+0000 --> 2024-01-02 06:00:00+0000; reasonCode = shortness of breath
> - Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#123456789986 (use: usual, ); status = finished; class = Inpatient Encounter (ActCode[9.0.0]#IMP); type = Hospital admission (procedure); period = 2024-01-02 06:01:00+0000 --> 2024-01-16 08:30:00+0000; reasonCode = shortness of breath
> - Coverage: identifier = Member Number: 88800933501; status = active; type = subsidized health program; subscriberId = 123456789; relationship = Self; period = 2023-01-01 --> (ongoing)
> - Condition COVID-19
> - MedicationAdministration: status = completed; medication[x] = ->Molnupiravir 200 mg PO BID; effective[x] = 2024-01-02 09:00:00+0000 --> 2024-01-06 08:59:09+0000
> - MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101903002 (use: usual, ); status = completed; intent = order; category = Inpatient; medication[x] = ->Molnupiravir 200 mg; authoredOn = 2024-01-02 21:30:15+0000; courseOfTherapyType = Short course (acute) therapy
> - Observation SARS-CoV-2 (COVID-19) N gene [Presence] in Specimen by Nucleic acid amplification using CDC primer-probe set N1
> - Observation SARS-CoV-2 (COVID-19) N gene [Presence] in Specimen by Nucleic acid amplification using CDC primer-probe set N1
> - ServiceRequest SARS-CoV-2 (COVID-19) N gene [Presence] in Specimen by Nucleic acid amplification using CDC primer-probe set N1
> - ServiceRequest SARS-CoV-2 (COVID-19) N gene [Presence] in Specimen by Nucleic acid amplification using CDC primer-probe set N1
> - Specimen: type = Nasal fluid specimen (specimen); receivedTime = 2024-01-01 08:30:00+0000
> - Specimen: type = Nasal fluid specimen (specimen); receivedTime = 2024-01-02 16:30:00+0000
> - Procedure Intubation of respiratory tract (procedure)

Entry 2 - fullUrl = http://nhsnlink.org/fhir/Patient/patient-example-ach-daily-negativepcr

Resource Patient:

> Profile: Cross-Measure Patient Profile

> ACHDaily NegativePCR(official) Other, DoB: 2005-02-01 ( MRN: 1000009001 (use: usual, ))

> Active: | true | Deceased: | false
> Contact Detail | ph: 999-999-9999(Home) 456 Alphabet Street Lansing MI 48864 US (home)
> US Core Ethnicity Extension: | ombCategory: Race & Ethnicity - CDC 2186-5: Not Hispanic or Latino text: Non Hispanic or Latino
> US Core Birth Sex Extension | F
> US Core Race Extension: | ombCategory: Race & Ethnicity - CDC 2028-9: Asian text: Asian

Entry 3 - fullUrl = http://nhsnlink.org/fhir/Encounter/encounter-example-ach-daily-negativepcr-1

Resource Encounter:

> Profile: ACH Daily Event Encounter

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.698.8`/123456789986 (use: usual, )

> status: completed

> class: Observation Encounter

> type: Hospital admission (procedure)

> subject: ACHDaily, NegativePCR

> > location

> > location: EMERGENCY - PAVILION

> > period: 2022-08-11 18:52:00+0000 --> 2022-08-17 16:09:00+0000

> > location

> > location: Health Hospital Location

> > period: 2022-08-17 16:09:00+0000 --> 2022-08-22 19:01:00+0000

Entry 4 - fullUrl = http://nhsnlink.org/fhir/Encounter/encounter-example-ach-daily-negativepcr-2

Resource Encounter:

> Profile: ACH Daily Event Encounter

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.698.8`/123456789986 (use: usual, )

> status: completed

> class: Inpatient Encounter

> type: Hospital admission (procedure)

> subject: ACHDaily, NegativePCR

> > location

> > location: EMERGENCY - PAVILION

> > period: 2022-08-11 18:52:00+0000 --> 2022-08-17 16:09:00+0000

> > location

> > location: Health Hospital Location

> > period: 2022-08-17 16:09:00+0000 --> 2022-08-22 19:01:00+0000

Entry 5 - fullUrl = http://nhsnlink.org/fhir/Coverage/coverage-example-ach-daily-negativepcr

Resource Coverage:

> identifier: Member Number/88800933501

> status: Active

> type: MEDICAID

> subscriberId: 123456789

> beneficiary: ACHDaily NegativePCR(official) Other, DoB: 2005-02-01 ( MRN: 1000009001 (use: usual, ))

> relationship: Self

> period: 2023-01-01 --> (ongoing)

> ### Classes

> - | Type | Value | Name
> * | Medicaid | Medicaid | Medicaid

Entry 6 - fullUrl = http://nhsnlink.org/fhir/Condition/condition-example-diagnosis-ach-daily-negativepcr

Resource Condition:

> Original Resource ID: eloBHVi6UskNwFJ55XgUq294CfCWyE3tytd.P4NomlhQprDjGoqWBeK2-ed8C2oMs3

> clinicalStatus: Active

> verificationStatus: Confirmed

> category: Encounter Diagnosis

> code: COVID-19

> subject: ACHDaily, NegativePCR

> encounter: Inpatient

Entry 7 - fullUrl = http://nhsnlink.org/fhir/MedicationAdministration/medadmin-example-ach-daily-negativepcr

Resource MedicationAdministration:

> Profile: ACH Daily Event Medication Administration

> status: completed

> subject: ACHDaily, NegativePCR

> request: MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101903002 (use: usual, ); status = completed; intent = order; category = Inpatient; medication[x] = ->Molnupiravir 200 mg; authoredOn = 2024-01-02 21:30:15+0000; courseOfTherapyType = Short course (acute) therapy

> ### Dosages

> - | Text | Route | Dose
> * | Take Molnupiravir 200 mg 4 capsules by mouth twice a day x 5 days | Capsule | 200 mg (Details: UCUM codemg = 'mg')

Entry 8 - fullUrl = http://nhsnlink.org/fhir/MedicationRequest/medicationrequest-example-ach-daily-negativepcr

Resource MedicationRequest:

> Profile: ACH Daily Event Medication Request

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/101903002 (use: usual, )

> status: Completed

> intent: Order

> category: Inpatient

> subject: ACHDaily, NegativePCR

> encounter: Hospital Encounter

> authoredOn: 2024-01-02 21:30:15+0000

> requester: Faculty Physician Um_Cln, MD

> recorder: Faculty Physician Um_Cln, MD

> courseOfTherapyType: Short course (acute) therapy

> ### DosageInstructions

> - | Text | Timing | Route
> * | Molnupiravir 200 mg: Take 4 capsules by mouth twice a day x 5 days | Code , 4 per 5 days | Oral use

Entry 9 - fullUrl = http://nhsnlink.org/fhir/Observation/lab-observation-example-ach-daily-negativepcr-1

Resource Observation:

> Profile: ACH Daily Event Lab Result Observation

> status: Final

> category: Laboratory

> code: SARS-CoV-2 (COVID-19) N gene NAA+probe CDC primer-probe set N1 Ql (Specimen)

> subject: ACHDaily, NegativePCR

> encounter: Hospital Encounter

> effective: 2023-01-01 08:30:00+0000

> issued: 2023-01-01 08:30:00+0000

> value: Positive

> specimen: Specimen: type = Nasal fluid specimen (specimen); receivedTime = 2024-01-01 08:30:00+0000

Entry 10 - fullUrl = http://nhsnlink.org/fhir/Observation/lab-observation-example-ach-daily-negativepcr-2

Resource Observation:

> Profile: ACH Daily Event Lab Result Observation

> status: Final

> category: Laboratory

> code: SARS-CoV-2 (COVID-19) N gene NAA+probe CDC primer-probe set N1 Ql (Specimen)

> subject: ACHDaily, NegativePCR

> encounter: Hospital Encounter

> effective: 2023-01-02 15:30:00+0000

> issued: 2023-01-02 15:30:00+0000

> value: Negative

> specimen: Specimen: type = Nasal fluid specimen (specimen); receivedTime = 2024-01-02 16:30:00+0000

Entry 11 - fullUrl = http://nhsnlink.org/fhir/ServiceRequest/servicerequest-example-ach-daily-negativepcr-covid-1

Resource ServiceRequest:

> Profile: ACH Daily Event ServiceRequest

> identifier: Placer Identifier/1019631821 (use: usual, )

> status: Completed

> intent: Original Order

> category: Laboratory procedure

> code: No display for ServiceRequest.code (concept: SARS-CoV-2 (COVID-19) N gene [Presence] in Specimen by Nucleic acid amplification using CDC primer-probe set N1)

> quantity: 1

> subject: ACHDaily NegativePCR

> encounter: Hospital Admission

> occurrence: Code , Events: 2024-02-02 17:22:00-0500 , Count 1 times, Once

> authoredOn: 2024-01-01 17:22:00-0500

> specimen: Specimen: type = Nasal fluid specimen (specimen); receivedTime = 2024-01-01 08:30:00+0000

Entry 12 - fullUrl = http://nhsnlink.org/fhir/ServiceRequest/servicerequest-example-ach-daily-negativepcr-covid-2

Resource ServiceRequest:

> Profile: ACH Daily Event ServiceRequest

> identifier: Placer Identifier/1019631821 (use: usual, )

> status: Completed

> intent: Original Order

> category: Laboratory procedure

> code: No display for ServiceRequest.code (concept: SARS-CoV-2 (COVID-19) N gene [Presence] in Specimen by Nucleic acid amplification using CDC primer-probe set N1)

> quantity: 1

> subject: ACHDaily NegativePCR

> encounter: Hospital Admission

> occurrence: Code , Events: 2024-02-02 17:22:00-0500 , Count 1 times, Once

> authoredOn: 2024-01-02 17:22:00-0500

> specimen: Specimen: type = Nasal fluid specimen (specimen); receivedTime = 2024-01-02 16:30:00+0000

Entry 13 - fullUrl = http://nhsnlink.org/fhir/Specimen/specimen-example-ach-daily-negativepcr-1

Resource Specimen:

> Profile: ACH Daily Event Specimen

> type: Nasal fluid specimen (specimen)

> subject: ACHDaily, NegativePCR

> receivedTime: 2024-01-01 08:30:00+0000

> ### Collections

> - | Collected[x] | BodySite
> * | 2024-01-01 09:00:00+0000 | No display for Specimen.collection.bodySite (concept: Entire root of nose (body structure))

Entry 14 - fullUrl = http://nhsnlink.org/fhir/Specimen/specimen-example-ach-daily-negativepcr-2

Resource Specimen:

> Profile: ACH Daily Event Specimen

> type: Nasal fluid specimen (specimen)

> subject: ACHDaily, NegativePCR

> receivedTime: 2024-01-02 16:30:00+0000

> ### Collections

> - | Collected[x] | BodySite
> * | 2024-01-02 15:45:00+0000 | No display for Specimen.collection.bodySite (concept: Entire root of nose (body structure))

Entry 15 - fullUrl = http://nhsnlink.org/fhir/Procedure/procedure-example-ach-daily-negativepcr-intubation

Resource Procedure:

> Profile: ACH Daily Event Procedure

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.698.8`/1000510352 (use: usual, )

> status: Completed

> code: Intubation of respiratory tract (procedure)

> subject: ACHDaily NegativePCR

> encounter: Hospital Admission