Communication (QDM)

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The CQI Workgroup reviewed this content in April 2018 based on QDM version 5.3. The content has been updated to reflect a change in QDM version 5.4. QDM version 5.4 removes the previous QDM datatypes "Communication, Patient to Provider", "Communication, Provider to Patient", and "Communication, Provider to Provider". QDM version 5.4 creates a new QDM datatype, "Communication, Performed". The previous QDM datatype mapping are retained for historical review.

QDM defines Communication as the transmission, receipt, or acknowledgement of information sent from a source to a recipient, such as from one clinician to another regarding findings, assessments, plans of care, consultative advice, instructions, educational resources, etc. It also may include the receipt of response from a patient with respect to any aspect of the care provided. Furthermore, it may include the conveying of information from provider to patient (e.g., results, findings, plans for care, medical advice, instructions, educational resources, appointments). A time and date stamp is required. QDM defines on QDM datatype, Communication, Performed.

FHIR Communication Resource
This resource is a record of a communication. A communication is a conveyance of information from one entity, a sender, to another entity, a receiver. The sender and receivers may be patients, practitioners, related persons, organizations, or devices. Communication use cases include:

• A reminder or alert delivered to a responsible provider
• A recorded notification from the nurse that a patient's temperature exceeds a value
• A notification to a public health agency of a patient presenting with a communicable disease reportable to the public health agency
• Patient educational material sent by a provider to a patient
• Non-patient specific communication use cases may include:
• A nurse call from a hall bathroom
• Advisory for battery service from a pump
  
  

HL7 FHIR Procedure Resource
The boundary between determining whether an action is a Procedure (training or counseling) as opposed to a Communication is based on whether there's a specific intent to change the mind-set of the patient. Mere disclosure of information would be considered a Communication. A process that involves verification of the patient's comprehension or to change the patient's mental state would be a Procedure.

QDM 5.4 Communication, Performed

QDM Attribute	QI Core Metadata Element	Comment
Communication, Performed	Communication.status	QDM matched to FHIR / QI Core (the .status metadata allows conformance to the specific QDM datatype context)
Code	Communication.reasonCode	Note - CommunicationRequest in QI Core could be considered but QDM does not differentiate a Communication recommended or ordered, only communication so the mapping assumes the communication has occurred, with or without a response.
Sender	Communication.sender	QDM matched to FHIR / QI Core
Recipient	Communication.recipient	QDM matched to FHIR / QI Core
Negation Rationale	Communication.notDoneReason	QDM matched to FHIR / QI Core
Medium	Communication.medium	QDM matched to FHIR / QI Core
Relevant Period	Communication.sent to Communication.received	QDM matched to FHIR / QI Core; Note - if interoperability is not present, the sending system may not have acknowledgement that the communication was received. In such situation, the QDM relevant period will have no end dateTime.
Author dateTime	Communication.sent	QDM addresses authorDatetime as the time the communication is sent.
Related to	Communication.basedOn	An order, proposal or plan fulfilled in whole or in part by this Communication.
id	Communication.id	QDM matched to FHIR / QI Core
Source	Communication.sender	The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication.

QDM 5.3 Communication, Patient to Provider

QDM Attribute	QI Core Metadata Element	Comment
Communication, Patient to Provider	Communication.status	QDM matched to FHIR / QI Core (the .status metadata allows conformance to the specific QDM datatype context)
Code	Communication.reasonCode	Note - CommunicationRequest in QI Core could be considered but QDM does not differentiate a Communication recommended or ordered, only communication so the mapping assumes the communication has occurred, with or without a response.
Negation Rationale	Communication.notDoneReason	QDM matched to FHIR / QI Core
Author dateTime	Communication.sent	QDM addresses authorDatetime as the time the communication is sent.
Related to	Communication.basedOn	An order, proposal or plan fulfilled in whole or in part by this Communication.
id	Communication.id	QDM matched to FHIR / QI Core
Source	Communication.sender	The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication.

QDM 5.3 Communication, Provider to Patient

QDM Attribute	QI Core Metadata Element	Comment
Communication, Provider to Patient	Communication.status	QDM matched to FHIR / QI Core (the .status metadata allows conformance to the specific QDM datatype context)
Code	Communication.reasonCode	Note - CommunicationRequest in QI Core could be considered but QDM does not differentiate a Communication recommended or ordered, only communication so the mapping assumes the communication has occurred, with or without a response.
Negation Rationale	Communication.notDoneReason	QDM matched to FHIR / QI Core
Author dateTime	Communication.sent	QDM addresses authorDatetime as the time the communication is sent.
Related to	Communication.basedOn	An order, proposal or plan fulfilled in whole or in part by this Communication.
id	Communication.id	QDM matched to FHIR / QI Core
Source	Communication.sender	The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication.

QDM 5.3 Communication, Provider to Provider

QDM Attribute	QI Core Metadata Element	Comment
Communication, Provider to Provider	Communication.status	QDM matched to FHIR / QI Core (the .status metadata allows conformance to the specific QDM datatype context)
Code	Communication.reasonCode	Note - CommunicationRequest in QI Core could be considered but QDM does not differentiate a Communication recommended or ordered, only communication so the mapping assumes the communication has occurred, with or without a response.
Negation Rationale	Communication.notDoneReason	QDM matched to FHIR / QI Core
Author dateTime	Communication.sent	QDM addresses authorDatetime as the time the communication is sent.
Related to	Communication.basedOn	An order, proposal or plan fulfilled in whole or in part by this Communication.
id	Communication.id	QDM matched to FHIR / QI Core
Source	Communication.sender	The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication.

Communication, Performed - Consideration for Future Use (QDM 5.4)

QDM Attribute	QI Core Metadata Element	Comment
Communication, Performed	Communication.status	QDM matched to FHIR / QI Core (the .status metadata allows conformance to the specific QDM datatype context, constrained to "completed")
Code	Communication.reasonCode	The reason or justification for the communication.
Sender	Communication.sender	The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication.
Recipient	Communication.recipient	The entity (e.g. person, organization, clinical information system, or device) which was the target of the communication.
Negation Rationale	Communication.notDoneReason	Describes why the communication event did not occur in coded and/or textual form.
Relevant Period	Communication.sent Communication.received	QDM matched to FHIR
Author dateTime	FHIR.provenance.recorded	QDM matched to FHIR
Medium	Communication.medium	A channel that was used for this communication (e.g. email, fax).
Related to	Communication.basedOn	An order, proposal or plan fulfilled in whole or in part by this Communication.
id	Communication.id	QDM matched to FHIR / QI Core
Sender	Communication.sender	The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication.