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 Monthly Submission Subject Bundle 2

Profile: NHSN Subject Bundle

Bundle bundle-example-ach-monthly-subject-ach-pass2 of type collection

Entry 1 - fullUrl = http://nhsnlink.org/fhir/MeasureReport/measurereport-example-individual-ach-monthly-pass2

Resource MeasureReport:

> Profile: DEQM Individual MeasureReport Profile

> DEQM Measure Scoring Extension: Cohort

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Pass2 ACH(official) Female, DoB: 1965-12-22 ( MRN: 1601191902010308 (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#10005104252a (use: usual, ); status = triaged; class = emergency (ActCode[9.0.0]#EMER); type = Emergency department patient visit; period = 2024-01-31 02:35:00-0500 --> 2024-01-31 22:02:00-0500; reasonCode = Pain in right lower leg

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Encounter: extension = eloBHVi6UskNwFJ55XgUq294CfCWyE3tytd.P4NomlhQprDjGoqWBeK2-ed8C2oMs3; identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#10005104252b (use: usual, ); status = finished; class = inpatient encounter (ActCode[9.0.0]#IMP); type = Hospital admission (procedure); period = 2024-01-31 22:02:00-0500 --> 2024-02-02 16:22:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Coverage: identifier = Member Number: 93565936; status = active; type = health maintenance organization policy; subscriberId = 89345743; relationship = Self

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Condition Diabetes mellitus type 2 (disorder)

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Condition Thrombophlebitis of deep femoral vein (disorder)

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Device: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#100051034 (use: usual, ); type = Graduated compression elastic hosiery (physical object)

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Diagnostic Report for 'Doppler ultrasonography of vascular structure of right lower limb (procedure)' for '->Pass2 ACH'

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888893 (use: usual, ); status = completed; category = Outpatient; medication[x] = ->Dex4 4 gm chewable tablet X1; effective[x] = 2024-01-31 04:54:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888895 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->0.5 ML heparin sodium, porcine 10000 UNT/ML Prefilled Syringe; effective[x] = 2024-02-01 12:22:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888895 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->0.5 ML heparin sodium, porcine 10000 UNT/ML Prefilled Syringe; effective[x] = 2024-02-02 13:26:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888942 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Insulin Lispro; effective[x] = 2024-02-01 12:00:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888943 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Insulin Lispro; effective[x] = 2024-02-01 19:00:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888944 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Insulin Lispro; effective[x] = 2024-02-02 07:00:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888945 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Insulin Lispro; effective[x] = 2024-02-02 15:00:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888892 (use: usual, ); status = active; intent = plan; category = Outpatient; reported[x] = true; medication[x] = ->Dex4 4 gm chewable tablet X1; authoredOn = 2024-01-31 04:46:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888895 (use: usual, ); status = completed; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->0.5 ML heparin sodium, porcine 10000 UNT/ML Prefilled Syringe; authoredOn = 2024-02-01 12:00:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888894 (use: usual, ); status = completed; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->Insulin Lispro; authoredOn = 2024-02-01 12:00:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888892 (use: usual, ); status = active; intent = plan; category = Community; reported[x] = true; medication[x] = ->Metformin hydrochloride 1000 MG; authoredOn = 2024-01-31 04:22:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Observation aPTT in Blood by Coagulation assay

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Observation Glucose [Mass/volume] in Capillary blood by Glucometer

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Observation Glucose [Mass/volume] in Capillary blood by Glucometer

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Observation Hemoglobin A1c/Hemoglobin.total in Blood

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Observation Bacteria identified in Blood by Culture

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Observation Body weight

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Procedure Percutaneous insertion of inferior vena cava filter (procedure)

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): ServiceRequest aPTT in Blood by Coagulation assay

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): ServiceRequest Glucose [Mass/volume] in Capillary blood by Glucometer

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): ServiceRequest Hemoglobin A1c [Mass/volume] in Blood

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): ServiceRequest Hemoglobin [Mass/volume] in Venous blood

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082902,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:42; type = Venous blood specimen (specimen); receivedTime = 2024-01-31 22:50:00-0500

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082902,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:42; type = Venous blood specimen (specimen); receivedTime = 2024-02-02 11:26:00-0500

> identifier: `http://example.org/fhir/measurereport/id`/123456789-pass2

> status: Complete

> type: Individual

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

> subject: Pass1 ACH(official) Female, DoB: 2024-02-01 ( MRN: 1601191901010308 (use: usual, ))

> date: 2024-02-05 21:04:29+0000

> reporter: Organization Example NHSN Submitter

> period: 2024-01-05 00:00:00+0000 --> 2024-02-04 00:00:00+0000

> improvementNotation: Increased score indicates improvement

> > group

> > ### Populations

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

> evaluatedResource:

> - Pass2 ACH(official) Female, DoB: 1965-12-22 ( MRN: 1601191902010308 (use: usual, ))
> - Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#10005104252a (use: usual, ); status = triaged; class = emergency (ActCode[9.0.0]#EMER); type = Emergency department patient visit; period = 2024-01-31 02:35:00-0500 --> 2024-01-31 22:02:00-0500; reasonCode = Pain in right lower leg
> - Encounter: extension = eloBHVi6UskNwFJ55XgUq294CfCWyE3tytd.P4NomlhQprDjGoqWBeK2-ed8C2oMs3; identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#10005104252b (use: usual, ); status = finished; class = inpatient encounter (ActCode[9.0.0]#IMP); type = Hospital admission (procedure); period = 2024-01-31 22:02:00-0500 --> 2024-02-02 16:22:00-0500
> - Coverage: identifier = Member Number: 93565936; status = active; type = health maintenance organization policy; subscriberId = 89345743; relationship = Self
> - Condition Diabetes mellitus type 2 (disorder)
> - Condition Thrombophlebitis of deep femoral vein (disorder)
> - Device: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#100051034 (use: usual, ); type = Graduated compression elastic hosiery (physical object)
> - Diagnostic Report for 'Doppler ultrasonography of vascular structure of right lower limb (procedure)' for '->Pass2 ACH'
> - MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888893 (use: usual, ); status = completed; category = Outpatient; medication[x] = ->Dex4 4 gm chewable tablet X1; effective[x] = 2024-01-31 04:54:00-0500
> - MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888895 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->0.5 ML heparin sodium, porcine 10000 UNT/ML Prefilled Syringe; effective[x] = 2024-02-01 12:22:00-0500
> - MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888895 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->0.5 ML heparin sodium, porcine 10000 UNT/ML Prefilled Syringe; effective[x] = 2024-02-02 13:26:00-0500
> - MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888942 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Insulin Lispro; effective[x] = 2024-02-01 12:00:00-0500
> - MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888943 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Insulin Lispro; effective[x] = 2024-02-01 19:00:00-0500
> - MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888944 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Insulin Lispro; effective[x] = 2024-02-02 07:00:00-0500
> - MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888945 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Insulin Lispro; effective[x] = 2024-02-02 15:00:00-0500
> - MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888892 (use: usual, ); status = active; intent = plan; category = Outpatient; reported[x] = true; medication[x] = ->Dex4 4 gm chewable tablet X1; authoredOn = 2024-01-31 04:46:00-0500
> - MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888895 (use: usual, ); status = completed; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->0.5 ML heparin sodium, porcine 10000 UNT/ML Prefilled Syringe; authoredOn = 2024-02-01 12:00:00-0500
> - MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888894 (use: usual, ); status = completed; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->Insulin Lispro; authoredOn = 2024-02-01 12:00:00-0500
> - MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888892 (use: usual, ); status = active; intent = plan; category = Community; reported[x] = true; medication[x] = ->Metformin hydrochloride 1000 MG; authoredOn = 2024-01-31 04:22:00-0500
> - Observation aPTT in Blood by Coagulation assay
> - Observation Glucose [Mass/volume] in Capillary blood by Glucometer
> - Observation Glucose [Mass/volume] in Capillary blood by Glucometer
> - Observation Hemoglobin A1c/Hemoglobin.total in Blood
> - Observation Bacteria identified in Blood by Culture
> - Observation Body weight
> - Procedure Percutaneous insertion of inferior vena cava filter (procedure)
> - ServiceRequest aPTT in Blood by Coagulation assay
> - ServiceRequest Glucose [Mass/volume] in Capillary blood by Glucometer
> - ServiceRequest Hemoglobin A1c [Mass/volume] in Blood
> - ServiceRequest Hemoglobin [Mass/volume] in Venous blood
> - Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082902,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:42; type = Venous blood specimen (specimen); receivedTime = 2024-01-31 22:50:00-0500
> - Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082902,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:42; type = Venous blood specimen (specimen); receivedTime = 2024-02-02 11:26:00-0500

Entry 2 - fullUrl = http://nhsnlink.org/fhir/Patient/patient-example-ach-monthly-pass2

Resource Patient:

> Profile: Cross-Measure Patient Profile

> Pass2 ACH(official) Female, DoB: 1965-12-22 ( MRN: 1601191902010308 (use: usual, ))

> Active: | true | Deceased: | 2024-02-02 16:22:00-0500
> Contact Detail | ph: 999-999-9999(Home) 123 Sesame Street Lansing Lansing MI 48864 US
> 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 2106-3: White text: White

Entry 3 - fullUrl = http://nhsnlink.org/fhir/Encounter/encounter-example-ach-monthly-pass2-emergency

Resource Encounter:

> Profile: ACH Monthly Event Encounter

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.698.8`/10005104252a (use: usual, )

> status: In Progress

> class: emergency

> type: Emergency department patient visit

> subject: Pass2 ACH

> ### Diagnoses

> - | Condition
> * | No display for Encounter.diagnosis.condition (reference: ->Thrombophlebitis)

> ### Locations

> - | Location | Period
> * | ACH Monthly Emergency Department | 2024-01-31 02:35:00-0500 --> 2024-02-01 01:02:00-0500

Entry 4 - fullUrl = http://nhsnlink.org/fhir/Encounter/encounter-example-ach-monthly-pass2-inpatient

Resource Encounter:

> Profile: ACH Monthly Event Encounter

> Original Resource ID: eloBHVi6UskNwFJ55XgUq294CfCWyE3tytd.P4NomlhQprDjGoqWBeK2-ed8C2oMs3

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.698.8`/10005104252b (use: usual, )

> status: completed

> class: inpatient encounter

> type: Hospital Admission

> subject: Pass2 ACH

> ### Locations

> - | Location | Period
> * | ACH Monthly Inpatient Hospital Ward | 2024-02-01 01:02:00-0500 --> 2024-02-02 16:22:00-0500

Entry 5 - fullUrl = http://nhsnlink.org/fhir/Coverage/coverage-example-ach-monthly-pass2

Resource Coverage:

> Profile: ACH Monthly Event Coverage

> identifier: Member Number/93565936

> status: Active

> type: health maintenance organization policy

> subscriberId: 89345743

> beneficiary: Pass2 ACH(official) Female, DoB: 1965-12-22 ( MRN: 1601191902010308 (use: usual, ))

> relationship: Self

Entry 6 - fullUrl = http://nhsnlink.org/fhir/Condition/condition-example-diagnosis-ach-monthly-pass2-problem

Resource Condition:

> Profile: ACH Monthly Event Condition

> clinicalStatus: Active

> verificationStatus: Confirmed

> category: Problem List Item

> code: Diabetes mellitus without complication

> subject: Pass2 ACH

Entry 7 - fullUrl = http://nhsnlink.org/fhir/Condition/condition-example-diagnosis-ach-monthly-pass2

Resource Condition:

> Profile: ACH Monthly Event Condition

> clinicalStatus: Active

> verificationStatus: Confirmed

> category: Encounter Diagnosis

> code: Thrombophlebitis

> subject: Pass2 ACH

Entry 8 - fullUrl = http://nhsnlink.org/fhir/Device/device-example-ach-monthly-pass2-compress-hose

Resource Device:

> Profile: ACH Monthly Event Device

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.698.8`/100051034 (use: usual, )

> type: Graduated compression elastic hosiery

Entry 9 - fullUrl = http://nhsnlink.org/fhir/DiagnosticReport/diagnosticreport-example-ach-monthly-pass2-radiology

Resource DiagnosticReport:

> Profile: ACH Monthly Event Diagnostic Report - Report and Note

> ## ultrasonography of right lower limb (Radiology)

> Subject | Pass2 ACH(official) Female, DoB: 1965-12-22 ( MRN: 1601191902010308 (use: usual, ))
> When For | 2024-02-01 23:14:00-0500
> Reported | 2024-02-02 08:52:00-0500

> Report Details

> Coded Conclusions:

> - Deep venous thrombosis (disorder)

Entry 10 - fullUrl = http://nhsnlink.org/fhir/MedicationAdministration/medadmin-example-ach-monthly-pass2-dex4

Resource MedicationAdministration:

> Profile: ACH Monthly Event MedicationAdministration

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/101888893 (use: usual, )

> status: completed

> category: Outpatient

> subject: Pass2 ACH

> request: MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888892 (use: usual, ); status = active; intent = plan; category = Outpatient; reported[x] = true; medication[x] = ->Dex4 4 gm chewable tablet X1; authoredOn = 2024-01-31 04:46:00-0500

> ### Dosages

> - | Text | Route | Dose
> * | 4 gm chewable tablet X1 | Oral | 4 g (Details: UCUM codeg = 'g')

Entry 11 - fullUrl = http://nhsnlink.org/fhir/MedicationAdministration/medadmin-example-ach-monthly-pass2-heparin-1

Resource MedicationAdministration:

> Profile: ACH Monthly Event MedicationAdministration

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/101888895 (use: usual, )

> status: completed

> category: Inpatient Medication

> subject: Pass2 ACH

> request: MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888895 (use: usual, ); status = completed; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->0.5 ML heparin sodium, porcine 10000 UNT/ML Prefilled Syringe; authoredOn = 2024-02-01 12:00:00-0500

> ### Dosages

> - | Text | Site | Route | Dose
> * | 0.5 mL | Structure of blood vessel of left upper arm (body structure) | IV | 5000 uL (Details: UCUM codeuL = 'uL')

Entry 12 - fullUrl = http://nhsnlink.org/fhir/MedicationAdministration/medadmin-example-ach-monthly-pass2-heparin-2

Resource MedicationAdministration:

> Profile: ACH Monthly Event MedicationAdministration

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/101888895 (use: usual, )

> status: completed

> category: Inpatient Medication

> subject: Pass2 ACH

> request: MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888895 (use: usual, ); status = completed; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->0.5 ML heparin sodium, porcine 10000 UNT/ML Prefilled Syringe; authoredOn = 2024-02-01 12:00:00-0500

> ### Dosages

> - | Text | Site | Route | Dose
> * | 0.5 mL | Structure of blood vessel of left upper arm (body structure) | IV | 5000 uL (Details: UCUM codeuL = 'uL')

Entry 13 - fullUrl = http://nhsnlink.org/fhir/MedicationAdministration/medadmin-example-ach-monthly-pass2-insulin-lispro-1

Resource MedicationAdministration:

> Profile: ACH Monthly Event MedicationAdministration

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/1018888942 (use: usual, )

> status: completed

> category: Inpatient Medication

> subject: Pass2 ACH

> request: MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888894 (use: usual, ); status = completed; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->Insulin Lispro; authoredOn = 2024-02-01 12:00:00-0500

> ### Dosages

> - | Text | Site | Route | Dose
> * | Give 5 units before breakfast | Structure of blood vessel of left upper arm (body structure) | IV | 5

Entry 14 - fullUrl = http://nhsnlink.org/fhir/MedicationAdministration/medadmin-example-ach-monthly-pass2-insulin-lispro-2

Resource MedicationAdministration:

> Profile: ACH Monthly Event MedicationAdministration

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/1018888943 (use: usual, )

> status: completed

> category: Inpatient Medication

> subject: Pass2 ACH

> request: MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888894 (use: usual, ); status = completed; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->Insulin Lispro; authoredOn = 2024-02-01 12:00:00-0500

> ### Dosages

> - | Text | Site | Route | Dose
> * | Give 5 units before dinner | Structure of blood vessel of left upper arm (body structure) | IV | 4

Entry 15 - fullUrl = http://nhsnlink.org/fhir/MedicationAdministration/medadmin-example-ach-monthly-pass2-insulin-lispro-3

Resource MedicationAdministration:

> Profile: ACH Monthly Event MedicationAdministration

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/1018888944 (use: usual, )

> status: completed

> category: Inpatient Medication

> subject: Pass2 ACH

> request: MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888894 (use: usual, ); status = completed; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->Insulin Lispro; authoredOn = 2024-02-01 12:00:00-0500

> ### Dosages

> - | Text | Site | Route | Dose
> * | Give 5 units before breakfast | Structure of blood vessel of left upper arm (body structure) | IV | 5

Entry 16 - fullUrl = http://nhsnlink.org/fhir/MedicationAdministration/medadmin-example-ach-monthly-pass2-insulin-lispro-4

Resource MedicationAdministration:

> Profile: ACH Monthly Event MedicationAdministration

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/1018888945 (use: usual, )

> status: completed

> category: Inpatient Medication

> subject: Pass2 ACH

> request: MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888894 (use: usual, ); status = completed; intent = order; category = Inpatient; reported[x] = false; medication[x] = ->Insulin Lispro; authoredOn = 2024-02-01 12:00:00-0500

> ### Dosages

> - | Text | Site | Route | Dose
> * | Give 5 units before dinner | Structure of blood vessel of left upper arm (body structure) | IV | 4

Entry 17 - fullUrl = http://nhsnlink.org/fhir/MedicationRequest/medicationrequest-example-ach-monthly-pass2-dex4-tablet

Resource MedicationRequest:

> Profile: ACH Monthly Event MedicationRequest

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/101888892 (use: usual, )

> status: Active

> intent: Plan

> category: Outpatient

> subject: Pass2 ACH

> encounter: Emergency Encounter

> authoredOn: 2024-01-31 04:46:00-0500

> requester: Pass2 ACH(official) Female, DoB: 1965-12-22 ( MRN: 1601191902010308 (use: usual, ))

> > dosageInstruction

> > text: 4 gm chewable tablet X1

> > timing: Once per 1 day

> > route: Oral

> > ### DoseAndRates

> > - | Type | Dose[x]
> > * | calculated | 4 g (Details: UCUM codeg = 'g')

Entry 18 - fullUrl = http://nhsnlink.org/fhir/MedicationRequest/medicationrequest-example-ach-monthly-pass2-heparin

Resource MedicationRequest:

> Profile: ACH Monthly Event MedicationRequest

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/101888895 (use: usual, )

> status: Completed

> intent: Order

> category: Inpatient Medication

> subject: Pass2 ACH

> encounter: Hospital Admission

> authoredOn: 2024-02-01 12:00:00-0500

> requester: Pass2 ACH(official) Female, DoB: 1965-12-22 ( MRN: 1601191902010308 (use: usual, ))

> > dosageInstruction

> > text: 0.5 mL

> > timing: 2 per 1 day

> > site: Structure of blood vessel of left upper arm (body structure)

> > route: IV

> > ### DoseAndRates

> > - | Dose[x]
> > * | 5000 uL (Details: UCUM codeuL = 'uL')

Entry 19 - fullUrl = http://nhsnlink.org/fhir/MedicationRequest/medicationrequest-example-ach-monthly-pass2-insulin-lispro

Resource MedicationRequest:

> Profile: ACH Monthly Event MedicationRequest

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/101888894 (use: usual, )

> status: Completed

> intent: Order

> category: Inpatient Medication

> subject: Pass2 ACH

> encounter: Hospital Admission

> authoredOn: 2024-02-01 12:00:00-0500

> requester: Pass2 ACH(official) Female, DoB: 1965-12-22 ( MRN: 1601191902010308 (use: usual, ))

> > dosageInstruction

> > text: Give 5 units before breakfast

> > timing: Code , Once per 1 day

> > site: Structure of blood vessel of left upper arm (body structure)

> > route: IV

> > ### DoseAndRates

> > - | Dose[x]
> > * | 5

> > dosageInstruction

> > text: Give 4 units before dinner

> > timing: Code , Once per 1 day

> > site: Structure of blood vessel of left upper arm (body structure)

> > route: IV

> > ### DoseAndRates

> > - | Dose[x]
> > * | 4

Entry 20 - fullUrl = http://nhsnlink.org/fhir/MedicationRequest/medicationrequest-example-ach-monthly-pass2-metformin

Resource MedicationRequest:

> Profile: ACH Monthly Event MedicationRequest

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798`/101888892 (use: usual, )

> status: Active

> intent: Plan

> category: Home Medication

> subject: Pass2 ACH

> encounter: Emergency Encounter

> authoredOn: 2024-01-31 04:22:00-0500

> requester: Pass2 ACH(official) Female, DoB: 1965-12-22 ( MRN: 1601191902010308 (use: usual, ))

> recorder: Patient Identified

> > dosageInstruction

> > text: 1000 mg tablet by mouth twice daily

> > timing: 2 per 1 day

> > route: Oral

> > ### DoseAndRates

> > - | Type | Dose[x]
> > * | calculated | 1000 mg (Details: UCUM codemg = 'mg')

Entry 21 - fullUrl = http://nhsnlink.org/fhir/Observation/observation-example-ach-monthly-pass2-aptt

Resource Observation:

> Profile: ACH Monthly Event Lab Result Observation

> basedOn: ServiceRequest aPTT in Blood by Coagulation assay

> status: Final

> category: Laboratory

> code: aPTT

> subject: Pass2 ACH

> encounter: Hospital Admission

> effective: 2024-02-02 11:24:00-0500

> issued: 2024-02-02 11:29:00-0500

> value: 8 s (Details: UCUM codes = 's')

> specimen: Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082902,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:42; type = Venous blood specimen (specimen); receivedTime = 2024-01-31 22:50:00-0500

Entry 22 - fullUrl = http://nhsnlink.org/fhir/Observation/observation-example-ach-monthly-pass2-poc-1

Resource Observation:

> Profile: ACH Monthly Event Lab Result Observation

> basedOn: ServiceRequest Glucose [Mass/volume] in Capillary blood by Glucometer

> status: Final

> category: Laboratory

> code: Glucose

> subject: Pass2 ACH

> encounter: Hospital Admission

> effective: 2024-01-31 23:01:00-0500

> issued: 2024-01-31 23:02:00-0500

> value: 53 d/gL (Details: UCUM codeg/dL = 'g/dL')

Entry 23 - fullUrl = http://nhsnlink.org/fhir/Observation/observation-example-ach-monthly-pass2-poc-2

Resource Observation:

> Profile: ACH Monthly Event Lab Result Observation

> basedOn: ServiceRequest Glucose [Mass/volume] in Capillary blood by Glucometer

> status: Final

> category: Laboratory

> code: Glucose

> subject: Pass2 ACH

> encounter: Hospital Admission

> effective: 2024-02-02 10:14:00-0500

> issued: 2024-02-02 10:15:00-0500

> value: 105 d/gL (Details: UCUM codeg/dL = 'g/dL')

Entry 24 - fullUrl = http://nhsnlink.org/fhir/Observation/observation-example-ach-monthly-pass2-hemo-a1c

Resource Observation:

> Profile: ACH Monthly Event Lab Result Observation

> basedOn: ServiceRequest Hemoglobin A1c [Mass/volume] in Blood

> status: Final

> category: Laboratory

> code: Hemoglobin A1c

> subject: Pass2 ACH

> encounter: Hospital Admission

> effective: 2024-01-31 23:01:00-0500

> issued: 2024-01-31 23:52:00-0500

> value: 7.5 % (Details: UCUM code% = '%')

> specimen: Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082902,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:42; type = Venous blood specimen (specimen); receivedTime = 2024-01-31 22:50:00-0500

Entry 25 - fullUrl = http://nhsnlink.org/fhir/Observation/observation-example-ach-monthly-pass2-hemo

Resource Observation:

> Profile: ACH Monthly Event Lab Result Observation

> basedOn: ServiceRequest Hemoglobin [Mass/volume] in Venous blood

> status: Final

> category: Laboratory

> code: Bacteria identified in Blood by Culture

> subject: Pass2 ACH

> encounter: Hospital Admission

> effective: 2024-02-02 11:24:00-0500

> issued: 2024-02-02 11:29:00-0500

> value: 8 d/gL (Details: UCUM codeg/dL = 'g/dL')

> specimen: Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082902,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:42; type = Venous blood specimen (specimen); receivedTime = 2024-02-02 11:26:00-0500

Entry 26 - fullUrl = http://nhsnlink.org/fhir/Observation/observation-example-ach-monthly-pass2-vitals-weight

Resource Observation:

> Profile: ACH Monthly Event Observation - Vital Signs

> status: Final

> category: Vital Signs

> code: Weight

> subject: Pass2 ACH

> encounter: Emergency Encounter

> effective: 2024-01-31 01:42:00-0500

> issued: 2024-01-31 01:42:00-0500

> value: 113.4 kg (Details: UCUM codekg = 'kg')

Entry 27 - fullUrl = http://nhsnlink.org/fhir/Procedure/procedure-example-ach-monthly-pass2-ivcf

Resource Procedure:

> Profile: ACH Monthly Event Procedure

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.698.8`/10005103526 (use: usual, )

> status: Completed

> code: Percutaneous insertion of inferior vena cava filter (procedure)

> subject: Pass2 ACH

> encounter: Hospital Admission

Entry 28 - fullUrl = http://nhsnlink.org/fhir/ServiceRequest/servicerequest-example-ach-monthly-pass2-aptt

Resource ServiceRequest:

> Profile: ACH Monthly Event ServiceRequest

> identifier: Placer Identifier/1019631824 (use: usual, )

> status: Completed

> intent: Original Order

> category: Laboratory procedure

> priority: STAT

> code: No display for ServiceRequest.code (concept: aPTT in Blood by Coagulation assay)

> quantity: 1

> subject: Pass2 ACH

> encounter: Hospital Admission

> occurrence: Code , Events: 2024-01-31 22:21:00-0500 , Count 1 times, Once

> authoredOn: 2024-01-31 22:21:00-0500

> specimen: Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082902,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:42; type = Venous blood specimen (specimen); receivedTime = 2024-01-31 22:50:00-0500

Entry 29 - fullUrl = http://nhsnlink.org/fhir/ServiceRequest/servicerequest-example-ach-monthly-pass2-glucose

Resource ServiceRequest:

> Profile: ACH Monthly Event ServiceRequest

> identifier: Placer Identifier/1019631824 (use: usual, )

> status: Completed

> intent: Original Order

> category: Laboratory procedure

> code: No display for ServiceRequest.code (concept: Glucose [Mass/volume] in Capillary blood by Glucometer)

> quantity: 2

> subject: Pass2 ACH

> encounter: Hospital Admission

> occurrence: Code , Count 2 times, Once per 1 day

> authoredOn: 2024-01-31 22:21:00-0500

Entry 30 - fullUrl = http://nhsnlink.org/fhir/ServiceRequest/servicerequest-example-ach-monthly-pass2-hemo-a1c

Resource ServiceRequest:

> Profile: ACH Monthly Event ServiceRequest

> identifier: Placer Identifier/1019631823 (use: usual, )

> status: Completed

> intent: Original Order

> category: Laboratory procedure

> code: No display for ServiceRequest.code (concept: Hemoglobin A1c [Mass/volume] in Blood)

> quantity: 1

> subject: Pass2 ACH

> encounter: Hospital Admission

> occurrence: Code , Events: 2024-01-31 22:21:00-0500 , Count 1 times, Once

> authoredOn: 2024-01-31 22:21:00-0500

> specimen: Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082902,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:42; type = Venous blood specimen (specimen); receivedTime = 2024-01-31 22:50:00-0500

Entry 31 - fullUrl = http://nhsnlink.org/fhir/ServiceRequest/servicerequest-example-ach-monthly-pass2-hemo

Resource ServiceRequest:

> Profile: ACH Monthly Event ServiceRequest

> identifier: Placer Identifier/1019631824 (use: usual, )

> status: Completed

> intent: Original Order

> category: Laboratory procedure

> priority: STAT

> code: No display for ServiceRequest.code (concept: Hemoglobin [Mass/volume] in Venous blood)

> quantity: 1

> subject: Pass2 ACH

> encounter: Hospital Admission

> occurrence: Code , Events: 2024-02-02 11:22:00-0500 , Count 1 times, Once

> authoredOn: 2024-02-02 11:22:00-0500

> specimen: Specimen: identifier = urn:oid:2.16.840.1.113883.19.5.1.798.32#C104082902,urn:oid:2.16.840.1.113883.19.5.1.798.800#C10408290:42; type = Venous blood specimen (specimen); receivedTime = 2024-02-02 11:26:00-0500

Entry 32 - fullUrl = http://nhsnlink.org/fhir/Specimen/specimen-example-ach-monthly-pass2-blood-1

Resource Specimen:

> Profile: ACH Monthly Event Specimen

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798.32`/C104082902, `urn:oid:2.16.840.1.113883.19.5.1.798.800`/C10408290:42

> type: Venous blood specimen (specimen)

> subject: Pass1 ACH

> receivedTime: 2024-01-31 22:50:00-0500

> ### Collections

> - | Collected[x] | BodySite
> * | 2024-01-31 22:42:00-0500 | No display for Specimen.collection.bodySite (concept: Structure of blood vessel of left upper arm (body structure))

Entry 33 - fullUrl = http://nhsnlink.org/fhir/Specimen/specimen-example-ach-monthly-pass2-blood-2

Resource Specimen:

> Profile: ACH Monthly Event Specimen

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.798.32`/C104082902, `urn:oid:2.16.840.1.113883.19.5.1.798.800`/C10408290:42

> type: Venous blood specimen (specimen)

> subject: Pass1 ACH

> receivedTime: 2024-02-02 11:26:00-0500

> ### Collections

> - | Collected[x] | BodySite
> * | 2024-02-02 11:24:00-0500 | No display for Specimen.collection.bodySite (concept: Structure of blood vessel of left upper arm (body structure))