End to End Submission Flow

Systems in End to End Submission Flow

• Client: Gathers data of interest, then assembles and executes submit-data request
• EHR: Data source for Client, implements FHIR API that supports query parameters needed to gather data of interest
• Receiving Server: Receives and stores data of interest, calculates measures and care gap reports
• Program Server: Provides functionality related to a specific quality program

The submit-data operation

The client executes the submit-data FHIR operation, which submits data-of-interest for a measure. Check out the operation spec for more information and examples.

Submission Flow Example using EXM130 Measure Bundle

To perform end to end submission flow, we will begin by EXM130 measure bundle. See Measure Bundle Upload for detailed instructions on sending the measure to the server.

After uploading the measure bundle, submit the following POST request:

POST http://localhost:3000/4_0_1/Measure/measure-EXM130-7.3.000/$submit-data

with the following JSON body:

{
  "resourceType": "Parameters",
  "parameter": [
    {
      "name": "measureReport",
      "resource": {
        "resourceType": "MeasureReport",
        "measure": "http://hl7.org/fhir/us/cqfmeasures/Measure/EXM130",
        "period": {
          "start": "2019-01-01",
          "end": "2019-12-31"
        }
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Encounter",
        "id": "numer-EXM130-4",
        "meta": {
          "profile": ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"]
        },
        "status": "finished",
        "class": {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code": "AMB",
          "display": "ambulatory"
        },
        "type": [
          {
            "coding": [
              {
                "system": "http://www.ama-assn.org/go/cpt",
                "code": "99201",
                "display": "Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family."
              }
            ]
          }
        ],
        "subject": {
          "reference": "Patient/numer-EXM130"
        },
        "period": {
          "start": "2019-05-30T00:00:00.0",
          "end": "2019-05-31T00:00:00.0"
        }
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Patient",
        "id": "numer-EXM130",
        "meta": {
          "profile": ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"]
        },
        "extension": [
          {
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race",
            "extension": [
              {
                "url": "ombCategory",
                "valueCoding": {
                  "system": "urn:oid:2.16.840.1.113883.6.238",
                  "code": "2028-9",
                  "display": "Asian"
                }
              }
            ]
          },
          {
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity",
            "extension": [
              {
                "url": "ombCategory",
                "valueCoding": {
                  "system": "urn:oid:2.16.840.1.113883.6.238",
                  "code": "2135-2",
                  "display": "Hispanic or Latino"
                }
              }
            ]
          }
        ],
        "identifier": [
          {
            "use": "usual",
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "MR",
                  "display": "Medical Record Number"
                }
              ]
            },
            "system": "http://hospital.smarthealthit.org",
            "value": "999999992"
          }
        ],
        "name": [
          {
            "family": "Blitz",
            "given": ["Don"]
          }
        ],
        "gender": "male",
        "birthDate": "1965-01-01"
      }
    },
    {
      "name": "resource",
      "resource": {
        "resourceType": "Procedure",
        "id": "numer-EXM130-1",
        "meta": {
          "profile": ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure"]
        },
        "status": "completed",
        "code": {
          "coding": [
            {
              "system": "http://www.ama-assn.org/go/cpt",
              "code": "44393",
              "display": "Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique"
            }
          ]
        },
        "subject": {
          "reference": "Patient/numer-EXM130"
        },
        "performedPeriod": {
          "start": "2010-01-01T00:00:00-06:00",
          "end": "2010-01-01T01:00:00-07:00"
        }
      }
    }
  ]
}

Upon successful evaluation, the server should return 200 OK status.