Example ACH Daily Submission Influenza Therapeutic Bundle - CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG v2.0.0

CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG
2.0.0 - Release 2 US

This page is part of the NHSN Digital Quality Measures (dQM) Content Package Implementation Guide (v2.0.0: Release) based on FHIR (HL7? FHIR? Standard) R4. This is the current published version. For a full list of available versions, 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:

Profiles: NHSN Individual MeasureReport, DEQM Individual MeasureReport Profile
Extension Definition for MeasureReport.supplementalData for Version 5.0: ACHDaily InfluenzaTherapeutic(official) Male, DoB: 2020-02-29 ( MRN:?1000009001?(use:?usual,?))
Extension Definition for MeasureReport.supplementalData for Version 5.0: Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#123456789987?(use:?usual,?); status = finished; class = Inpatient Acute (ActCode#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
Extension Definition for MeasureReport.supplementalData for Version 5.0: Location EMERGENCY - SYNTHETIC-001
Extension Definition for MeasureReport.supplementalData for Version 5.0: Coverage: identifier = Member Number: 88800933501; status = active; type = preferred provider organization policy; subscriberId = 123456789; relationship = Self; period = 2023-01-01 --> (ongoing)
Extension Definition for MeasureReport.supplementalData for Version 5.0: Condition Influenza due to identified novel influenza A virus
Extension Definition for MeasureReport.supplementalData for Version 5.0: 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
Extension Definition for MeasureReport.supplementalData for Version 5.0: 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
Extension Definition for MeasureReport.supplementalData for Version 5.0: Immunization: identifier = OID:1.3.6.1.4.1.21367.2005.3.7.1234; status = completed; vaccineCode = Influenza, split virus, trivalent, injectable, preservative free; occurrence[x] = 2024-01-02; primarySource = true; lotNumber = AAJN11K; expirationDate = 2025-02-15; doseQuantity = 5 mg; note = Notes on administration of vaccine; isSubpotent = true
DEQM Measure Scoring Extension: Cohort
identifier: http://example.org/fhir/measurereport/id/123456789-pass1
status: Complete
type: Individual
measure: NHSN Acute Care Hospital Daily Initial Population version: 2.0.0
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#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 = Influenza, split virus, trivalent, injectable, preservative free; 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
* ED-SYNTH-001 2024-01-14 08:00:00+0000 --> 2024-01-22 12:00:00+0000

Entry 4 - fullUrl = http://nhsnlink.org/fhir/Location/location-example-ach-daily-emergency

Resource Location:

Profile: ACH Daily Event Location
identifier: urn:oid:2.16.840.1.113883.19.5.1.6869/100001090?(use:?usual,?)
name: EMERGENCY - SYNTHETIC-001
alias: ED, EDSYNTH
mode: Instance
type: Emergency Department
address: 1234 1st Street Anytown CALIFORNIA 12345-6789

Entry 5 - 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 01X34765 Primary emp group

Entry 6 - 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 7 - 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 Oral route 60 mg (Details: UCUM codemg = 'mg')

Entry 8 - 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: Staff Physician, MD
recorder: Staff Physician, 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 9 - fullUrl = http://nhsnlink.org/fhir/Medication/medication-example-ach-daily-influenzatherapeutic

Resource Medication:

Profile: ACH Daily Event Medication
Original Resource ID: eZeW55xkBH0DrR0Xj004fNlA99h1sjXKwuhGs.PNpjjUi.Dh2-U-oGW0c9xZjPn2b29S.YZMgFiH.76i57tFS1PARcjzOMkC6TPHQQXiH6vA3
code: remdesivir 100 MG Injection
status: Active
ingredient

Entry 10 - fullUrl = http://nhsnlink.org/fhir/Immunization/immunization-example-ach-daily-influenzatherapeutic

Resource Immunization:

identifier: Uniform Resource Identifier (URI)/urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234
status: Completed
vaccineCode: Influenza, seasonal, injectable, preservative free
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#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

Entry 11 - fullUrl = http://nhsnlink.org/fhir/Organization/organization-coverage-example-nationfirst

Resource Organization:

Profile: US Core Organization Profile version: 6.1.0
active: true
name: Nation First Health Care

IG © 2026+ CDC National Healthcare Safety Network (NHSN). Package gov.cdc.nhsn.dqm#2.0.0 based on FHIR 4.0.1. Generated 2026-05-15
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