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

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 Initial Population Pass Bundle

Profile: NHSN Subject Bundle

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

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

Resource MeasureReport:

Profiles: NHSN Individual MeasureReport, DEQM Individual MeasureReport Profile
Extension Definition for MeasureReport.supplementalData for Version 5.0: ACHDaily, InitialPopulationPass(official) Female, DoB: 2005-01-15 ( 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 = emergency (ActCode#EMER); type = Emergency hospital admission (procedure); period = 2024-01-01 08:00:00+0000 --> 2024-01-01 12:00:00+0000; reasonCode = shortness of breath
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 encounter (ActCode#IMP); type = Medical consultation on hospital inpatient; period = 2024-01-14 08:00:00+0000 --> 2024-01-22 12:00:00+0000; reasonCode = Difficulty breathing
Extension Definition for MeasureReport.supplementalData for Version 5.0: Location EMERGENCY - SYNTHETIC-001
Extension Definition for MeasureReport.supplementalData for Version 5.0: Location Health Hospital Location
Extension Definition for MeasureReport.supplementalData for Version 5.0: Location ACH Daily Inpatient Hospital Ward
Extension Definition for MeasureReport.supplementalData for Version 5.0: Coverage: identifier = Member Number: 88800933501; status = active; type = subsidized health program; subscriberId = 123456789; relationship = Self; period = 2008-07-01 --> (ongoing)
Extension Definition for MeasureReport.supplementalData for Version 5.0: Condition Shortness of breath
Extension Definition for MeasureReport.supplementalData for Version 5.0: MedicationAdministration: status = completed; medication[x] = ->Remdesivir 200 mg IV; effective[x] = 2024-01-01 22:00:00+0000 --> 2024-01-02 22:00:09+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] = ->remdesivir 100 mg; authoredOn = 2024-01-14 21:30:15+0000; courseOfTherapyType = Short course (acute) therapy
Extension Definition for MeasureReport.supplementalData for Version 5.0: MedicationAdministration: status = completed; medication[x] = ->Remdesivir 100 mg IV; effective[x] = 2024-01-02 22:00:00+0000 --> 2024-01-05 22:00:09+0000
Extension Definition for MeasureReport.supplementalData for Version 5.0: Observation SARS-CoV-2 (COVID-19) RNA [Presence] in Respiratory system specimen by NAA with probe detection
Extension Definition for MeasureReport.supplementalData for Version 5.0: ServiceRequest SARS-CoV-2 (COVID-19) RNA [Presence] in Respiratory system specimen by NAA with probe detection
Extension Definition for MeasureReport.supplementalData for Version 5.0: Specimen: type = Nasal fluid specimen (specimen); receivedTime = 2024-01-01 08:30:00+0000
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, InitialPopulationPass(official) Female, DoB: 2005-01-15 ( MRN:?1000009001?(use:?usual,?))
date: 2024-02-05 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, InitialPopulationPass(official) Female, DoB: 2005-01-15 ( MRN:?1000009001?(use:?usual,?))
Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#123456789987?(use:?usual,?); status = finished; class = emergency (ActCode#EMER); type = Emergency hospital admission (procedure); period = 2024-01-01 08:00:00+0000 --> 2024-01-01 12:00:00+0000; reasonCode = shortness of breath
Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#123456789987?(use:?usual,?); status = finished; class = inpatient encounter (ActCode#IMP); type = Medical consultation on hospital inpatient; period = 2024-01-14 08:00:00+0000 --> 2024-01-22 12:00:00+0000; reasonCode = Difficulty breathing
Coverage: identifier = Member Number: 88800933501; status = active; type = subsidized health program; subscriberId = 123456789; relationship = Self; period = 2008-07-01 --> (ongoing)
Condition Shortness of breath
MedicationAdministration: status = completed; medication[x] = ->Remdesivir 200 mg IV; effective[x] = 2024-01-01 22:00:00+0000 --> 2024-01-02 22:00:09+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] = ->remdesivir 100 mg; authoredOn = 2024-01-14 21:30:15+0000; courseOfTherapyType = Short course (acute) therapy
MedicationAdministration: status = completed; medication[x] = ->Remdesivir 100 mg IV; effective[x] = 2024-01-02 22:00:00+0000 --> 2024-01-05 22:00:09+0000
Observation SARS-CoV-2 (COVID-19) RNA [Presence] in Respiratory system specimen by NAA with probe detection
ServiceRequest SARS-CoV-2 (COVID-19) RNA [Presence] in Respiratory system specimen by NAA with probe detection
Specimen: type = Nasal fluid specimen (specimen); receivedTime = 2024-01-01 08:30:00+0000

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

Resource Patient:

Profile: Cross-Measure Patient Profile
ACHDaily, InitialPopulationPass(official) Female, DoB: 2005-01-15 ( MRN:?1000009001?(use:?usual,?))
Active: true Deceased: false
Contact Detail
ph: 999-999-9999(Home)
123 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: 1002-5 (American Indian or Alaska Native)
text: Asian

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

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: emergency
type: Emergency hospital admission
subject: ACHDaily, InitialPopulationPass
location
location: ED-SYNTH-001
period: 2022-08-17 16:25:00+0000 --> 2022-08-17 17:01:00+0000
location
location: Health Hospital Location
period: 2022-08-11 18:52:00+0000 --> 2022-08-17 16:09:00+0000

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

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 encounter
type: Medical consultation on hospital inpatient
subject: ACHDaily, InitialPopulationPass
Locations
- Location Period
* Inpatient Hospital Ward 2024-01-14 09:00:00+0000 --> 2024-01-22 12:00:00+0000

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

Resource Coverage:

identifier: Member Number/88800933501
status: Active
type: MEDICARE
subscriberId: 123456789
beneficiary: ACHDaily, InitialPopulationPass(official) Female, DoB: 2005-01-15 ( MRN:?1000009001?(use:?usual,?))
relationship: Self
period: 2008-07-01 --> (ongoing)

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

Resource Condition:

Original Resource ID: eloBHVi6UskNwFJ55XgUq294CfCWyE3tytd.P4NomlhQprDjGoqWBeK2-ed8C2oMs3
clinicalStatus: Active
verificationStatus: Confirmed
category: Encounter Diagnosis
code: Hyperglycemia
subject: ACHDaily, InitialPopulationPass
encounter: Emergency

Entry 7 - fullUrl = http://nhsnlink.org/fhir/MedicationAdministration/medadmin-example-ach-daily-initialpopulationpass-1

Resource MedicationAdministration:

Profile: ACH Daily Event Medication Administration
status: completed
subject: ACHDaily, InitialPopulationPass
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] = ->remdesivir 100 mg; authoredOn = 2024-01-14 21:30:15+0000; courseOfTherapyType = Short course (acute) therapy
Dosages
- Text Route Dose
* Remdesivir 200 mg IV once a day on day 1, then 100 mg IV once a day on days 2-5 Intravenous use 200 mg (Details: UCUM codemg = 'mg')

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

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, InitialPopulationPass
encounter: Hospital Encounter
authoredOn: 2024-01-14 21:30:15+0000
requester: Staff Physician, MD
recorder: Staff Physician, MD
courseOfTherapyType: Short course (acute) therapy
DosageInstructions
- Text Timing Route
* Remdesivir 200 mg IV once a day on day 1, then 100 mg IV once a day on days 2-5 Code , 4 per 1 day Intravenous

Entry 9 - fullUrl = http://nhsnlink.org/fhir/MedicationAdministration/medadmin-example-ach-daily-initialpopulationpass-2

Resource MedicationAdministration:

Profile: ACH Daily Event Medication Administration
status: completed
subject: ACHDaily, InitialPopulationPass
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] = ->remdesivir 100 mg; authoredOn = 2024-01-14 21:30:15+0000; courseOfTherapyType = Short course (acute) therapy
Dosages
- Text Route Dose
* Remdesivir 200 mg IV once a day on day 1, then 100 mg IV once a day on days 2-5 Intravenous use 100 mg (Details: UCUM codemg = 'mg')

Entry 10 - fullUrl = http://nhsnlink.org/fhir/Medication/medication-example-ach-daily-initialpopulationpass

Resource Medication:

Profile: ACH Daily Event Medication
Original Resource ID: eZeW55xkBH0DrR0Xj004fNlA99h1sjXKwuhGs.PNpjjUi.Dh2-U-oGW0c9xZjPn2b29S.YZMgFiH.76i57tFS1PARcjzOMkC6TPHQQXiH6vA3
code: remdesivir 200 MG IV
status: Active
ingredient

Entry 11 - fullUrl = http://nhsnlink.org/fhir/Medication/medication-example-ach-daily-rsvlabbtg-1

Resource Medication:

Profile: ACH Daily Event Medication
Original Resource ID: eZeW55xkBH0DrR0Xj004fNlA99h1sjXKwuhGs.PNpjjUi.Dh2-U-oGW0c9xZjPn2b29S.YZMgFiH.76i57tFS1PARcjzOMkC6TPHQQXiH6vA3
code: ribavirin 600 MG Oral Tablet
status: Active
ingredient

Entry 12 - fullUrl = http://nhsnlink.org/fhir/Medication/medication-example-ach-daily-rsvlabbtg-2

Resource Medication:

Profile: ACH Daily Event Medication
Original Resource ID: eZeW55xkBH0DrR0Xj004fNlA99h1sjXKwuhGs.PNpjjUi.Dh2-U-oGW0c9xZjPn2b29S.YZMgFiH.76i57tFS1PARcjzOMkC6TPHQQXiH6vA3
code: Nasal Saline spray
status: Active
ingredient

Entry 13 - fullUrl = http://nhsnlink.org/fhir/Observation/lab-observation-example-ach-daily-initialpopulationpass

Resource Observation:

Profile: ACH Daily Event Lab Result Observation
status: Final
category: Laboratory
code: SARS-CoV-2 RNA Resp Ql NAA+probe
subject: ACHDaily, InitialPopulationPass
encounter: Hospital Encounter
effective: 2023-01-01 15:04:25+0000
issued: 2023-01-01 15:04:25+0000
value: Positive
specimen: Specimen: type = Nasal fluid specimen (specimen); receivedTime = 2024-01-01 08:30:00+0000

Entry 14 - fullUrl = http://nhsnlink.org/fhir/ServiceRequest/servicerequest-example-ach-daily-initialpopulationpass-covid

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) RNA [Presence] in Respiratory system specimen by NAA with probe detection)
quantity: 1
subject: ACHDaily InitialPopulationPass
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 15 - fullUrl = http://nhsnlink.org/fhir/Specimen/specimen-example-ach-daily-initialpopulationpass

Resource Specimen:

Profile: ACH Daily Event Specimen
type: Nasal fluid specimen (specimen)
subject: ACHDaily, InitialPopulationPass
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 16 - 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 17 - fullUrl = http://nhsnlink.org/fhir/Location/location-example-ach-daily-hospital

Resource Location:

Profile: ACH Daily Event Location
identifier: urn:oid:2.16.840.1.113883.19.5.1.6865/100?(use:?usual,?)
name: Health Hospital Location
mode: Instance
type: Hospital
address: 1234 1st Street Anytown CALIFORNIA 12345

Entry 18 - fullUrl = http://nhsnlink.org/fhir/Location/location-example-ach-daily-inpatient

Resource Location:

Profile: ACH Daily Event Location
identifier: http://www.example.org/location/2935
status: Active
name: ACH Daily Inpatient Hospital Ward
description:
ACH Daily Inpatient Hospital Ward

type: Medical ward