1. QRDA I STU R5 Updates Since pre-ballot content Review
July 28th , 2017 CQI WG Meeting
QRDA I STU R5 Updates Since pre-ballot content Review

2. QRDA I STU R5 Updates – Vol 2
Added latest QDM 5.3 updates (QDM Version 5.3 Annotated)
Added Related To attribute to:
Communication: from provider to patient
Communication: from patient to provider
Communication: from provider to provider
Assessment Performed
Modeled Related To as sdtc:isFulfillmentOf1 to allow reference to another QDM element instance
Changed Related To contained in Care Goal to this new Related To
Retired the Fulfills template
This operator was removed from QDM

3. QRDA I STU R5 Updates – Vol 2
Diagnostic Study Performed/Procedure Performed
Result – change from 0..* to 0..1 to match QDM spec
Laboratory Test Performed
No longer conforms to Result Observation, but instead contains Result Observation to support the Result and Result dateTime QDM attributes
Added SHALL NOT use observation/value, to ensure the consistency of using the Result Observation Template in Laboratory Test Performed
Now similar to Diagnostic Study Performed
Added Facility Location attribute to Encounter Order and Encounter Recommended (it was missed previously)
Corrected a few issues to the templates and example figures identified in the QA

4. QRDA I STU R5 Updates – Vol 2
Diagnostic Study Performed/Procedure Performed
Result – change from 0..* to 0..1 to match QDM spec
Laboratory Test Performed
No longer conforms to Result Observation, but instead contains Result Observation to support the Result and Result dateTime QDM attributes
Added SHALL NOT use observation/value, to ensure the consistency of using the Result Observation Template in Laboratory Test Performed
Now similar to Diagnostic Study Performed
Added Facility Location attribute to Encounter Order and Encounter Recommended (it was missed previously)

5. QRDA I STU R5 Updates – Vol 1
Updated the HQMF QDM Datatype to CDA Mapping Tables to align with the QDM-based HQMF Templates for CQL, R1, STU R2.1
The HQMF Templates STU R2.1 will be posted for CQI WG internal review, which includes changes made based on QDM 5.3

6. Ballot Package QRDA-I_CDAR2_QRDA_1_R1_S5_2017AUG.zip
Which contains the following materials

7. QDM-based HQMF Templates R1 STU 2.1, Volume 3 for member only review

8. Scope of Changes
Updated to align with the QDM Version 5.3 Annotated specification
Based on the Volume 3 of CQL-based HQMF IG R1, STU R2 (STU R2 was based on QDM Version 5.02)
See Chapter 8 Change Log for detailed changes

9. July 14th , 2017 CQI WG Meeting
HL7 QRDA I R1 STU R5 updates

10. Scope Update to support QDM v5.3
QRDA I STU R4 supports QDM v4.3
Remove the requirement of sdtc:valueSet
Support Direct Referenced Code
Duplicate data

11. Main QDM 5.3 Changes
Including changes in QDM 5.02 DRAFT, QDM 5.01 DRAFT, QDM 5.0 DRAFT
Added QDM data types:
Allergy/Intolerance
Adverse Event
Participation
new attribute to support: Participation Period.
Added QDM attributes:
Author Datetime
Diagnosis, Allergy/Intolerance, and Adverse Event
Device, Applied; Diagnostic Study, Performed; Intervention, Performed; Encounter, Performed; Laboratory Test, Performed; Medication, Administered; Physical Exam, Performed; Procedure, Performed; Substance, Administered. (V5.02)
Component
Assessment, Performed; Diagnostic, Performed; Laboratory Test, Performed. (V5.01)
Code
all data types
Timing: prevalence period, relevant period, Author Datetime
Admission Source and Discharge Disposition (replaces Discharge status) attributes for Encounter, Performed

12. Main QDM 5.3 Changes Other removal: Cardinality
Removed QDM data types:
Encounter, Active
all previous datatypes referencing Allergy, Intolerance and Adverse Reaction (V5.0)
Transfer to (V5.0)
Transfer from (V5.0)
Other removal:
Radiation Dose and Radiation Duration attributes
Reason attribute from Encounter, Performed
Cumulative Medication Duration has been removed as the concept can be expressed directly using existing QDM datatypes and attributes with CQL logic expressions (V5.0)
Cardinality

13. Timing author/time (Author Participation) effectiveTime (low and high)
Author Datetime
Active Datetime (Immunication Order, Medication Order)
effectiveTime (low and high)
Prevalence period
Relevant period
Expiration Datetime (Patient Characteristic Expired)
Incision Datetime
Location Period
Participation Period
Result Datetime
Cardinality

14. July 21st, 2017 CQI WG Meeting
HL7 QRDA I R1 STU R5 updates

15. Retired QDM Data Types Templates
Diagnostic Study Adverse Event
Diagnostic Study Intolerance
Device Intolerance
Device Allergy
Device Adverse Event
Intervention Adverse Event
Intervention Intolerance
Laboratory Test Adverse Event
Laboratory Test Intolerance
Procedure Adverse Event
Procedure Intolerance
Medication Adverse Effect
Medication Intolerance
Medication Allergy
Act Intolerance or Adverse Event Observation
Encounter Active
Transfer From Act/Transfer From
Transfer To Act/Transfer To

16. Retired Templates Due to QDM 5.3 updates
Radiation Dosage and Duration
Reaction
Due to removal of sdtc:valueSet
Result

17. Added Templates QDM data type templates QDM attributes templates
Adverse Event
Allergy Intolerance
Patient Characteristic Coverage Type
Participation
QDM attributes templates
Component
Related to (this was not new, but created a new template rather embedding)

18. legalAuthenticator
Removed the SHALL requirement in the QRDA Category I Framework template to align with the SHOULD requirement in US Realm Header

19. Not Done Removed the SHALL requirement of sdtc:valueSet
However, when report “not done”, If it is a value set
sdtc:valueSet will still be required
If it is direct referenced code
No sdtc:valueSet
<manufacturedMaterial>
<code nullFlavor="NA" sdtc:valueSet=" ">
<originalText>None of value set: Antibiotic Medications for Pharyngitis
</originalText>
</code>
</manufacturedMaterial>

20. Author dateTime Should QRDA use Author Participation C-CDA template?
<!-- C-CDA R2.1 Author Participation --> <templateId root=" "/> <time value=" "/> <assignedAuthor> <id root=" " extension=" "/> </assignedAuthor> </author>

21. Medication Administered Immunization Administered
Removed the outside act wrapper
Directly conform to Medication Activity/Immunization Activity