Care Experience (QDM)

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Reviewed by the CQI Workgroup on March 23 based on content posted to the CQI Workgroup document site. Updates based on that discussion entered on this wiki on 18 April 2018

QDM defines Care Experience as the experience a patient has when receiving care or a provider has when providing care. The individual Care Experience datatypes should be consulted for further details. QDM represents two kinds of care experience: Patient Care Experience and Provider Care Experience. The main question for the CQI Workgroup is whether Care Experience should be considered an observation, or is there some other concept present in or missing from FHIR.

Patient Care Experience

QDM Attribute	QI Core Metadata Element	Comment
Patient Care Experience	Observation.status	QDM matched to FHIR / QI Core (the .status metadata allows conformance to the specific QDM datatype context)
Code	Observation.code	QDM matched to FHIR / QI Core
Author dateTime	observation.effective.x	QDM matched to FHIR / QI Core - QDM only addresses authorTime; QI Core allows a Period. Patient Care Experience generally address specific documentation of observations. However, the experience may be referencing a specific period of time during which the patient was exposed to the healthcare system (e.g., Patient Care Experience during a hospitalization - i.e., with an admission dateTime and discharge dateTime to define the Relevant Period). Such concepts would use observation.effective.x. Consider authorDatetime for Patient Care Experience is the dateTime the experience is captured (i.e., the start of the effectiveTime).
id	Observation.id	QDM matched to FHIR / QI Core
Source	Observation.performer	QI Core / FHIR does not have a direct concept of "source" but it does list Observation.performer and Observation.device, both of which would address the QDM concept of Source.

Provider Care Experience

QDM Attribute	QI Core Metadata Element	Comment
Provider Care Experience	Observation.status	QDM matched to FHIR / QI Core (the .status metadata allows conformance to the specific QDM datatype context)
Code	Observation.code	QDM matched to FHIR / QI Core
Author dateTime	observation.effective.x	QDM matched to FHIR / QI Core - QDM only addresses authorTime; QI Core allows a Period. Patient Care Experience generally address specific documentation of observations. However, the experience may be referencing a specific period of time during which the patient was exposed to the healthcare system (e.g., Patient Care Experience during a hospitalization - i.e., with an admission dateTime and discharge dateTime to define the Relevant Period). Such concepts would use observation.effective.x. Consider authorDatetime for Patient Care Experience is the dateTime the experience is captured (i.e., the start of the effectiveTime).
id	Observation.id	QDM matched to FHIR / QI Core
Source	Observation.performer	QI Core / FHIR does not have a direct concept of "source" but it does list Observation.performer and Observation.device, both of which would address the QDM concept of Source.