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 Influenza Therapeutic Bundle

Profile: NHSN Subject Bundle

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

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

Resource MeasureReport:

> Profile: DEQM Individual MeasureReport Profile

> DEQM Measure Scoring Extension: Cohort

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): ACHDaily InfluenzaTherapeutic(official) Male, DoB: 2020-02-29 ( 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#123456789987 (use: usual, ); status = finished; class = Inpatient Acute (ActCode[9.0.0]#ACUTE); type = Emergency hospital admission (procedure); period = 2024-01-01 08:00:00+0000 --> 2024-01-04 12:00:00+0000; reasonCode = Fever with chills

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

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Condition Influenza due to identified novel influenza A virus

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): MedicationAdministration: status = completed; medication[x] = ->Oseltamivir 60 mg PO; effective[x] = 2024-01-01 20:00:00+0000 --> 2024-01-04 20:00:09+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] = ->Oseltamivir 60 mg; authoredOn = 2024-01-01 11:45:15+0000; courseOfTherapyType = Short course (acute) therapy

> Measure Report Supplemental Data Element Reference (R5 surrogate extension): Immunization: identifier = OID:1.3.6.1.4.1.21367.2005.3.7.1234; status = completed; vaccineCode = Fluvax; occurrence[x] = 2024-01-02; primarySource = true; lotNumber = AAJN11K; expirationDate = 2025-02-15; doseQuantity = 5 mg; note = Notes on administration of vaccine; isSubpotent = true

> 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 InfluenzaTherapeutic(official) Male, DoB: 2020-02-29 ( MRN: 1000009001 (use: usual, ))

> date: 2024-01-06 00:04:29+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 InfluenzaTherapeutic(official) Male, DoB: 2020-02-29 ( MRN: 1000009001 (use: usual, ))
> - Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#123456789987 (use: usual, ); status = finished; class = Inpatient Acute (ActCode[9.0.0]#ACUTE); type = Emergency hospital admission (procedure); period = 2024-01-01 08:00:00+0000 --> 2024-01-04 12:00:00+0000; reasonCode = Fever with chills
> - Coverage: identifier = Member Number: 88800933501; status = active; type = preferred provider organization policy; subscriberId = 123456789; relationship = Self; period = 2023-01-01 --> (ongoing)
> - Condition Influenza due to identified novel influenza A virus
> - MedicationAdministration: status = completed; medication[x] = ->Oseltamivir 60 mg PO; effective[x] = 2024-01-01 20:00:00+0000 --> 2024-01-04 20:00:09+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] = ->Oseltamivir 60 mg; authoredOn = 2024-01-01 11:45:15+0000; courseOfTherapyType = Short course (acute) therapy
> - Immunization: identifier = OID:1.3.6.1.4.1.21367.2005.3.7.1234; status = completed; vaccineCode = Fluvax; occurrence[x] = 2024-01-02; primarySource = true; lotNumber = AAJN11K; expirationDate = 2025-02-15; doseQuantity = 5 mg; note = Notes on administration of vaccine; isSubpotent = true

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

Resource Patient:

> Profile: Cross-Measure Patient Profile

> ACHDaily InfluenzaTherapeutic(official) Male, DoB: 2020-02-29 ( MRN: 1000009001 (use: usual, ))

> Active: | true | Deceased: | false
> Contact Detail | ph: 999-999-9999(Home) 789 Alphabet Street Lansing MI 48864 US (home)
> mother: | Mama Bear 789 Alphabet Street Lansing MI 48864 US (home)
> US Core Ethnicity Extension: | ombCategory: Race & Ethnicity - CDC 2135-2: Hispanic or Latino text: Hispanic or Latino
> US Core Birth Sex Extension | M
> US Core Race Extension: | ombCategory: Race & Ethnicity - CDC 2054-5: Black or African American text: Black or African American

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

Resource Encounter:

> Profile: ACH Daily Event Encounter

> identifier: `urn:oid:2.16.840.1.113883.19.5.1.698.8`/123456789987 (use: usual, )

> status: completed

> class: Inpatient Acute

> type: Emergency hospital admission

> subject: ACHDaily, InfluenzaTherapeutic

> ### Locations

> - | Location | Period
> * | EMERGENCY - PAVILION | 2024-01-14 08:00:00+0000 --> 2024-01-22 12:00:00+0000

Entry 4 - fullUrl = http://nhsnlink.org/fhir/Coverage/coverage-example-ach-daily-influenzatherapeutic

Resource Coverage:

> identifier: Member Number/88800933501

> status: Active

> type: PPO

> subscriberId: 123456789

> beneficiary: ACHDaily InfluenzaTherapeutic(official) Male, DoB: 2020-02-29 ( MRN: 1000009001 (use: usual, ))

> relationship: Self

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

> ### Classes

> - | Type | Value | Name
> * | PPO | United Healthcare | United Healthcare

Entry 5 - fullUrl = http://nhsnlink.org/fhir/Condition/condition-example-diagnosis-ach-daily-influenzatherapeutic

Resource Condition:

> Original Resource ID: eloBHVi6UskNwFJ55XgUq294CfCWyE3tytd.P4NomlhQprDjGoqWBeK2-ed8C2oMs3

> clinicalStatus: Active

> verificationStatus: Confirmed

> category: Encounter Diagnosis

> code: Influenza Type A

> subject: ACHDaily, InfluenzaTherapeutic

> encounter: Inpatient

Entry 6 - fullUrl = http://nhsnlink.org/fhir/MedicationAdministration/medadmin-example-ach-daily-influenzatherapeutic

Resource MedicationAdministration:

> Profile: ACH Daily Event Medication Administration

> status: completed

> subject: ACHDaily, InfluenzaTherapeutic

> 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] = ->Oseltamivir 60 mg; authoredOn = 2024-01-01 11:45:15+0000; courseOfTherapyType = Short course (acute) therapy

> ### Dosages

> - | Text | Route | Dose
> * | Oseltamivir 60 mg PO twice daily x 5 days | Capsule | 60 mg (Details: UCUM codemg = 'mg')

Entry 7 - fullUrl = http://nhsnlink.org/fhir/MedicationRequest/medicationrequest-example-ach-daily-influenzatherapeutic

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, InfluenzaTherapeutic

> encounter: Hospital Encounter

> authoredOn: 2024-01-01 11:45:15+0000

> requester: Faculty Physician Um_Cln, MD

> recorder: Faculty Physician Um_Cln, MD

> courseOfTherapyType: Short course (acute) therapy

> ### DosageInstructions

> - | Text | Timing | Route
> * | Oseltamivir 60 mg PO twice daily x 5 days | Code , 2 per 5 days | Oral use

Entry 8 - fullUrl = http://nhsnlink.org/fhir/Immunization/immunization-example-ach-daily-influenzatherapeutic

Resource Immunization:

> identifier: URI/urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234

> status: Completed

> vaccineCode: Fluvax

> lotNumber: AAJN11K

> expirationDate: 2025-02-15

> patient: ACHDaily InfluenzaTherapeutic(official) Male, DoB: 2020-02-29 ( MRN: 1000009001 (use: usual, ))

> encounter: Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#123456789987 (use: usual, ); status = finished; class = Inpatient Acute (ActCode[9.0.0]#ACUTE); type = Emergency hospital admission (procedure); period = 2024-01-01 08:00:00+0000 --> 2024-01-04 12:00:00+0000; reasonCode = Fever with chills

> occurrence: 2024-01-02

> primarySource: true

> doseQuantity: 5 mg (Details: UCUM codemg = 'mg')

> note:

> > Notes on administration of vaccine

> isSubpotent: true