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

## Artifact Listing

Page standards status: Informative

This page provides an organized list of the primary Fast Healthcare Interoperability Resources (FHIR) artifacts defined as part of this implementation guide.

### Current NHSN Report Submissions

Note: By default, a modifier extension may not be included in Report Submission Bundle data for NHSN until NHSN accepts the meaning of the said. See Modifier Extensions for additional information.

Title | Description
--- | ---
NHSN MeasureReport Bundle | This profile defines a valid Submission Bundle to NHSN with all resources contained within. The Bundle is comprised of entry slices representing the data source Organization, a Patients of Interest (POI) List, one Subject List MeasureReport per reportable measure, an Individual MeasureReport List, individual MeasureReports, and the underlying patient-centric clinical information.
NHSN Submission Header Bundle | This profile defines a valid Submission Header Bundle. The Bundle is comprised of entry slices representing a Patient, individual MeasureReports, and the underlying patient-centric clinical information.
NHSN Subject Bundle | This profile defines a valid subject-specific dQM Bundle. The Bundle is comprised of entry slices representing a Patient, individual MeasureReports, and the underlying patient-centric clinical information.
Subject-List MeasureReport Profile | A Subject-List MeasureReport contains the count of subjects (i.e. patients) in the Initial Population. It also references the Individual MeasureReport List.
NHSN Individual MeasureReport List | An Individual MeasureReport List contains references to all Individual MeasureReports for a given NHSN measure; each MeasureReport pertains to an individual patient within the Initial Population of a given measure.
Patients-Of-Interest List | A Patients of Interest List defines all individual Patients considered for inclusion in NHSN Measure reporting.

### Cross-Measure Profiles

Title | Description
--- | ---
Cross-Measure Patient Profile | This profile contains NHSN-specific Required and Must-Support elements for reporting Patient information on public-health surveillance measures to NHSN. This profile is based on US Core Patient 3.1.1. NHSN only recognizes the data element 'sex', with male and female as the only accepted responses. These data are mapped from either the patient.extension (birthsex), or patient.gender FHIR standard data elements. These two FHIR standard data elements provide male/female options, per US Core 3.1.1. For data submitted for patient.gender, and/or patient.extension (birthsex) that do not align with male or female, NHSN will label those responses as not reported. As national standards update, this resource will also be updated.
NHSN Submitting Organization | This profile includes the name and identifier of the organization submitting the report Bundle, and may include other information about the organization.
NHSN Submitting Device | This profile includes the name and version of the device or software submitting the report Bundle, and may include other information about the device.

### Acute Care Hospital (ACH) Monthly Reporting Profiles

Title | Description
--- | ---
ACH Monthly Event Encounter | This profile contains Required and Must Support data elements for reporting encounter information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile is based on the HL7 FHIR® US Core Encounter Profile v3.1.1.
ACH Monthly Event Location | This profile contains Required and Must Support data elements for reporting location information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile is based on the HL7 FHIR® US Core Location Profile v3.1.1.
ACH Monthly Event Lab Result Observation | This profile contains Required and Must Support data elements for reporting laboratory result information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile is based on the HL7 FHIR® US Core Lab Observation Profile v3.1.1.
ACH Monthly Event Observation - Vital Signs | This profile contains Required and Must Support data elements for reporting observation-vital signs information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile is based on the HL7 FHIR® R4 Observation Vital Signs Profile v4.0.1.
ACH Monthly Event Observation | This profile contains Required and Must Support data elements for reporting observation information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile is based on the HL7 FHIR® R4 Observation Resource v4.0.1.
ACH Monthly Event ServiceRequest | This profile contains Required and Must Support data elements for reporting order information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile is based on the HL7 FHIR® R4 ServiceRequest Profile v4.0.1.
ACH Monthly Event Specimen | This profile contains Required and Must Support data elements for reporting specimen information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile is based on the HL7 FHIR® R4 Specimen Profile v4.0.1.
ACH Monthly Event Condition | This profile contains Required and Must Support data elements for reporting patient condition information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile is based on the HL7 FHIR® US Core Condition Profile v3.1.1.
ACH Monthly Event Procedure | This profile contains Required and Must Support data elements for reporting procedure information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile is based on the HL7 FHIR® US Core Procedure Profile v3.1.1.
ACH Monthly Event Coverage | This profile contains Required and Must Support data elements for reporting coverage information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile is based on the HL7 FHIR® R4 Coverage Profile v4.0.1.
ACH Monthly Event Device | This profile contains Required and Must Support data elements for reporting device information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile covers both implantable and other types of devices and is based on the HL7 FHIR® R4 Device Resource v4.0.1.
ACH Monthly Event General Diagnostic Report | This profile contains Required and Must Support data elements for reporting general diagnostic report information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile is based on the HL7 FHIR® R4 DiagnosticReport Resource v4.0.1.
ACH Monthly Event Diagnostic Report (Lab) | This profile contains Required and Must Support data elements for reporting diagnostic report lab information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile is based on the HL7 FHIR® US Core Diagnostic Report - Lab Profile v3.1.1.
ACH Monthly Event Diagnostic Report - Report and Note | This profile contains Required and Must Support data elements for reporting diagnostic report- report and note information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile is based on the HL7 FHIR® US Core Diagnostic Report - Report and Note Exchange.
ACH Monthly Event Medication | This profile contains Required and Must Support data elements for reporting medication information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile is based on the HL7 FHIR® US Core Medication Profile v3.1.1.
ACH Monthly Event MedicationAdministration | This profile contains Required and Must Support data elements for reporting medication administration information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile is based on the HL7 FHIR® R4 MedicationAdministration Resource v4.0.1.
ACH Monthly Event MedicationRequest | This profile contains Required and Must Support data elements for reporting medication request (order) information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile is based on the HL7 FHIR® US Core MedicationRequest Profile v3.1.1.

### ACH Daily Event Reporting Profiles

Title | Description
--- | ---
ACH Daily Event Encounter | This profile contains Required and Must Support data elements for reporting encounter information for the NHSN Acute Care Hospital (ACH) Daily Digital Quality Measure. This profile is based on the HL7 FHIR® US Core Encounter Profile v3.1.1.
ACH Daily Event Location | This profile contains Required and Must Support data elements for reporting location information for the NHSN Acute Care Hospital (ACH) Daily Digital Quality Measure. This profile is based on the HL7 FHIR® US Core Location Profile v3.1.1.
ACH Daily Event Lab Result Observation | This profile contains Required and Must Support data elements for reporting COVID-19, Influenza, and Respiratory Syncytial Virus (RSV) Daily laboratory result information for the NHSN Acute Care Hospital (ACH) Daily Digital Quality Measure. This profile is based on the HL7 FHIR® US Core Laboratory Result Observation Profile v3.1.1.
ACH Daily Event ServiceRequest | This profile contains Required and Must Support data elements for reporting COVID-19, Influenza, and Respiratory Syncytial Virus (RSV) laboratory order information for the NHSN Acute Care Hospital (ACH) Daily Digital Quality Measure. This profile is based on the HL7 FHIR R4 ServiceRequest Resource v4.0.1.
ACH Daily Event Specimen | This profile contains Required and Must Support data elements for reporting COVID-19, Influenza, and Respiratory Syncytial Virus (RSV) specimen information for the NHSN Acute Care Hospital (ACH) Daily Digital Quality Measure. This profile is based on the HL7 FHIR R4 Specimen Resource v4.0.1.
ACH Daily Event Procedure | This profile contains Required and Must Support data elements for reporting transmission-based precaution procedure information for the NHSN Acute Care Hospital (ACH) Daily Digital Quality Measure. This profile is based on the HL7 FHIR® US Core Procedure Profile v3.1.1.
ACH Daily Event Diagnostic Report (Lab) | This profile contains Required and Must Support data elements for reporting diagnostic report lab information for the NHSN Acute Care Hospital (ACH) Daily Digital Quality Measure. This profile is based on the HL7 FHIR® US Core Diagnostic Report - Lab Profile v3.1.1.
ACH Daily Event Medication | This profile contains Required and Must Support data elements for reporting medication information for the NHSN Acute Care Hospital (ACH) Daily Digital Quality Measure. This profile is based on the HL7 FHIR® US Core Medication Profile v3.1.1.
ACH Daily Event Medication Administration | This profile contains Required and Must Support data elements for reporting medication administration information for the NHSN Acute Care Hospital (ACH) Daily Digital Quality Measure. This profile is based on the HL7 FHIR R4 MedicationAdministration Resource v4.0.1.
ACH Daily Event Medication Request | This profile contains Required and Must Support data elements for reporting medication request (order) information for the NHSN Acute Care Hospital (ACH) Daily Digital Quality Measure. This profile is based on the HL7 FHIR® US Core MedicationRequest Profile v3.1.1.
ACH Daily Event Observation | This profile contains Required and Must Support data elements for reporting observation information for the NHSN Acute Care Hospital (ACH) Daily Digital Quality Measure. This profile is based on the HL7 FHIR® R4 Observation Resource v4.0.1.

### Terminology: Profile ValueSets

Title | Description
--- | ---
ACH Monthly Encounter Status ValueSet | A set of codes indicating the status of the encounter.
ACH Monthly Encounter Class ValueSet | A set of codes indicating the encounter class that represent inpatient, emergency, observation and short stay concepts.
ACH Daily Diagnostic Report Status ValueSet | A set of codes indicating the status of the diagnostic report.
ACH Daily Encounter Status ValueSet | A set of codes indicating the status of the encounter.
ACH Daily Encounter Class ValueSet | A set of codes indicating the encounter class that represent inpatient, observation and short stay concepts.

### Knowledge Artifacts: Digital Quality Measures

Title | Description
--- | ---
NHSN ACH Monthly Initial Population Measure | The ACH Monthly Initial Population includes all encounters for patients of any age in an emergency department (ED), observation, or inpatient location or all encounters for patients of any age with an ED, observation, inpatient, or short stay status during the measurement period.
NHSN ACH Daily Initial Population Measure | All encounters with an inpatient, observation, or short stay status for patients of any age during the measurement period.

### Knowledge Artifacts: Measure Libraries

Title | Description
--- | ---
NHSN ACH Monthly Initial Population Library | Library of NHSN dQM ACH Monthly Initial Population Measure
NHSN ACH Daily Initial Population Library | Library of NHSN ACH Daily Initial Population Measure

### Knowledge Artifacts: Helper and External Libraries

Title | Description
--- | ---
Shared Resource Creation | A library used to remove data elements from FHIR resources that are deemed unnecessary and/or unwanted by NHSN.
NHSN Helpers | This library is a collection of commonly used functions from various third party libraries and other created functions for use within the NHSN Measures.
FHIR Helpers | This library defines functions to convert between FHIR data types and CQL system-defined types, as well as functions to support FHIRPath implementation. For more information, the FHIRHelpers wiki page: https://github.com/cqframework/clinical_quality_language/wiki/FHIRHelpers

### Extensions

Title | Description
--- | ---
Received Date | This extension stores the date and time a Resource was received by the processing system (e.g. NHSNLink).
Patient List Applicable Period | An extension used to indicate the reporting period associated with the patients of interest List.
Original Resource ID | This extension stores the original {Resource}.id of a source that was modified by a processing system (e.g. NHSNLink) to make it usable for NHSN when the original did not meet FHIR-standard requirements. Resource IDs that are more than 64 characters long are not valid per the FHIR specification and must be modified.
Original Element Value | This extension stores the original value of an element from a source that was modified by a processing system (e.g., NHSNLink) to make it usable for NHSN. Modification may include changing logically invalid data, changing data that does not match specification requirements (this modification is used sparingly, for specific instances only), or normalizing data.
Original Mapped Concept | This extension stores an original Concept that was mapped during processing.

### CQF Tooling Extensions

Externally defined extentions that have not been published.

Title | Description
--- | ---
Measure Report Supplemental Data Element Reference (R5 surrogate extension) | This extension is not defined by this IG. CQF Tooling uses this extension, but the extension is yet unpublished.
Measure Report Criteria Reference (R5 surrogate extension) | This extension is not defined by this IG. CQF Tooling uses this extension, but the extension is yet unpublished.

### Examples: ACH Monthly Submission Instances

Title | Description
--- | ---
Full ACH Monthly Measure Submission Bundle | Measure Bundle - Full ACH Monthly Measure Submission Example
Example ACH Monthly Submission Header Bundle | Example Separated ACH Monthly Submission Header Bundle
Example ACH Monthly Submission Subject Bundle 1 | Example Separated ACH Monthly Submission Subject Bundle 1 for LOS/MEN
Example ACH Monthly Submission Subject Bundle 2 | Example Separated ACH Monthly Submission Subject Bundle 2 for Hypoglycemia and VTE
Example ACH Monthly Submission Subject Bundle 3 | Example Separated ACH Monthly Submission Subject Bundle 3 for CDI and VTE

### Examples: ACH Daily Submission Instances

Title | Description
--- | ---
Full ACH Daily Measure Submission Bundle | Measure Bundle - Full ACH Daily Measure Submission Example
Example ACH Daily Submission Header Bundle | Example Separated ACH Daily Submission Header Bundle
Example ACH Daily Submission Initial Population Pass Bundle | Example Separated ACH Daily Submission Initial Population Pass Bundle
Example ACH Daily Submission Negative PCR Bundle | Example Separated ACH Daily Submission Negative PCR Bundle
Example ACH Daily Submission Influenza Therapeutic Bundle | Example Separated ACH Daily Submission Influenza Therapeutic Bundle
Example ACH Daily Submission RSV Lab BTG Bundle | Example Separated ACH Daily Submission RSV Lab BTG Bundle