We are using HL7 CDA® R2 Implementation Guide: Quality Reporting Document Architecture Category I (QRDA I), Release 1, STU Release 5 to gather and create template level functional specs required for 2019.

We are looking for below clarifications for Medication Order template since we are not seeing any Cypress patient with both the tags (mentioned below), which we used to see in 2018 patient files. Please see attached patient file from Cypress for 2018 MP.

We see that

1) <effectiveTime xsi:type="PIVL_TS" operator="A"> is not a SHALL condition for 2019. Are we suppose to print it in QRDA1 file for the measures that requires CMD calculation (Ex. CMS156) ?

2) <repeatNumber> is a MAY condition. Are we suppose to print it in QRDA1 file for the measures that requires CMD calculation? Will it be validated by Cypress tool in 2019?

3) As per our understanding, medication order is a single point in time when the order was placed by the provider and not the duration for how long (lets say the 90days or so) it is placed. Hence the low and high value should be same.

Since PIVL effectiveTime is not required anymore, can we print different low and high values for <effectiveTime xsi:type="IVL_TS"> tag as below?

*<effectiveTime xsi:type="IVL_TS">
<low value="2017*0106*083000"/>
<high value="2017*0410*083000"/>
</effectiveTime>*

4) In general, what is the recommended workflow for Medication Order template with CMD calculation required by the measure?