QDM includes the attribute "anatomical approach site" defined as "The anatomical site or structure through which the action represented by the datatype reaches, or should reach, its target." This attribute is distinct from the "anatomical location site" defined as The anatomical site or structure (a) where the diagnosis/problem manifests itself, or (b) that is the focus of the action represented by the datatype.
The following QDM datatypes include the "anatomical approach site" attribute:
• Device, Applied
• Procedure, Order
• Procedure, Performed
• Procedure, Recommended
In reviewing QDM mapping to HL7 FHIR and QI Core resources, the HL7 Clinical Quality Information Work Group determined that there is no corresponding metadata element in the HL7 FHIR DeviceUseStatement resource (to address Device, Applied). Similarly, there is no corresponding metadata element in the HL7 FHIR Procedure resource (used for QDM Procedure, Performed) or in the HL7 FHIR ProcedureRequest resource (used for QDM Procedure, Order and Procedure, Recommended). This QDM attribute has not been used as of this printing in an eCQM. The information desired can be addressed using the QDM datatype Procedure, Performed to specify the procedure as a pre-coordinated term that addresses the anatomical site and the anatomical approach site as part of the procedure code from existing code systems.

To the QDM User Group:
Should QDM remove the "anatomical approach site" attribute entirely?