Specification - Extended HL7 CDA® R2 Implementation Guide: Quality Reporting Document Architecture I (QRDA I) Release 1, STU Release 5.2 - US Realm
Document Description extended per TSC approval Jira TSC-68, errata by CTO
Existing WordingCurrently in the IG, the QDM attribute frequency for the Medication Active, Medication Order, Medication Discharge, Medication Dispensed, Substance Administered, Substance Order, Substance Recommended data types are represented following the established CDA approach for representing medication frequencies, which is to use effectiveTime following patterns documented by the CDA Example Task Force (https://docs.google.com/document/d/1Y0Z458o_MrR2aPnpx6EygO6hpI88Bl95esjRWZ0agtY/edit). However, since eCQM specifications are specifying frequency using value set, as we have seen in https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS249v2.html, this introduces a mismatch between frequency representation in eCQM specification and QRDA templates. Implementer needs to convert the coded frequency to numerical timing representation using effectiveTime. DosesPerDay(frequency Code) case when frequency ~ "Once daily (qualifier value)" then 1.0 when frequency ~ "Twice a day (qualifier value)" then 2.0 when frequency ~ "Three times daily (qualifier value)" then 3.0 when frequency ~ "Four times daily (qualifier value)" then 4.0 when frequency ~ "Every twenty four hours (qualifier value)" then 1.0 when frequency ~ "Every twelve hours (qualifier value)" then 2.0 when frequency ~ "Every thirty six hours (qualifier value)" then 0.67 when frequency ~ "Every eight hours (qualifier value)" then 3.0 when frequency ~ "Every four hours (qualifier value)" then 6.0 when frequency ~ "Every six hours (qualifier value)" then 4.0 when frequency ~ "Every seventy two hours (qualifier value)" then 0.34 when frequency ~ "Every forty eight hours (qualifier value)" then 0.5 when frequency ~ "Every eight to twelve hours (qualifier value)" then 2.0 when frequency ~ "Every six to eight hours (qualifier value)" then 3.0 when frequency ~ "Every three to four hours (qualifier value)" then 6.0 when frequency ~ "Every three to six hours (qualifier value)" then 4.0 when frequency ~ "Every two to four hours (qualifier value)" then 6.0 when frequency ~ "One to four times a day (qualifier value)" then 4.0 when frequency ~ "One to three times a day (qualifier value)" then 3.0 when frequency ~ "One to two times a day (qualifier value)" then 2.0 when frequency ~ "Two to four times a day (qualifier value)" then 4.0 else null end
Proposed WordingFor QDM data types noted above, add template to represent QDM attribute frequency as coded to better align with how this is used in eCQM specifications.