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<!-- QRDA Header -->
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<!-- US Realm Header Template Id -->
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<!-- QRDA templateId -->
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<!-- QDM-based QRDA templateId -->
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<!-- This is the globally unique identifier for this QRDA document -->
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<!-- QRDA document type code -->
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<title>QRDA Incidence Report</title>
<!-- This is the document creation time -->
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    </addr>
    <telecom use="WP" value="tel:+1-781-271-3000"/>
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      <name>
        <given>Troy</given>
        <family>Mckinney</family>
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      <birthTime value="19630918163000"/>
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      </languageCommunication>
    </patient>
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    <!-- NPI -->
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      <country>US</country>
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    <!-- CMS EHR Certification Number (formerly known as Office of the 
        National Coordinator Certification Number) -->
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</participant><documentationOf typeCode="DOC">
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    <!-- care provision -->
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    <!-- You can include multiple performers, each with an NPI, TIN, CCN. -->
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        <low nullFlavor="UNK"/>
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        <assignedPerson>
          <name>
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      <section>
        <!-- 
          *****************************************************************
          Measure Section
          *****************************************************************
        -->
        <!-- This is the templateId for Measure Section -->
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        <!-- This is the templateId for Measure Section QDM -->
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        <!-- This is the LOINC code for "Measure document". This stays the same for all measure section required by QRDA standard -->
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        <title>Measure Section</title>
        <text>
          <table border="1" width="100%">
            <thead>
              <tr>
                <th>eMeasure Title</th>
                <th>Version specific identifier</th>
              </tr>
            </thead>
            <tbody>
              <tr>
                <td>This measure assesses the number of patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given the day of or the day after hospital admission or surgery end date for surgeries that start the day of or the day after hospital admission</td>
                <td>40280382-6258-7581-0162-693C3D8A07C9</td>
                <td/>
              </tr>
            </tbody>
          </table>
        </text>
        <!-- 1..* Organizers, each containing a reference to an eMeasure -->
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          <organizer classCode="CLUSTER" moodCode="EVN">
            <!-- This is the templateId for Measure Reference -->
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            <!-- This is the templateId for eMeasure Reference QDM -->
            <templateId root="2.16.840.1.113883.10.20.24.3.97"/>
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            <statusCode code="completed"/>
            <!-- Containing isBranch external references -->
            <reference typeCode="REFR">
              <externalDocument classCode="DOC" moodCode="EVN">
                <!-- SHALL: This is the version specific identifier for eMeasure: QualityMeasureDocument/id it is a GUID-->
                <id extension="40280382-6258-7581-0162-693C3D8A07C9" root="2.16.840.1.113883.4.738"/>
                <!-- SHOULD This is the title of the eMeasure -->
                <text>This measure assesses the number of patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given the day of or the day after hospital admission or surgery end date for surgeries that start the day of or the day after hospital admission</text>
                <!-- SHOULD: setId is the eMeasure version neutral id  -->
                <setId root="38B0B5EC-0F63-466F-8FE3-2CD20DDD1622"/>
              </externalDocument>
            </reference>
          </organizer>
        </entry>
      </section>
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        <templateId extension="2016-03-01" root="2.16.840.1.113883.10.20.17.2.1.1"/>
        <code code="55187-9" codeSystem="2.16.840.1.113883.6.1"/>
        <title>Reporting Parameters</title>
        <text></text>
        <entry typeCode="DRIV">
          <act classCode="ACT" moodCode="EVN">
            <!-- This is the templateId for Reporting Parameteres Act -->
            <templateId root="2.16.840.1.113883.10.20.17.3.8"/>
            <templateId extension="2016-03-01" root="2.16.840.1.113883.10.20.17.3.8.1"/>
            <id extension="a642f890-a1d3-0136-f8ef-0e95690c4dba" root="1.3.6.1.4.1.115"/>
            <code code="252116004" codeSystem="2.16.840.1.113883.6.96" displayName="Observation Parameters"/>
            <effectiveTime>
              <low value="20170101000000"/>
              <high value="20171231235959"/>
            </effectiveTime>
          </act>
        </entry>
      </section>
    </component>    <component>
        <section>
          <!-- This is the templateId for Patient Data section -->
          <templateId root="2.16.840.1.113883.10.20.17.2.4"/>
          <!-- This is the templateId for Patient Data QDM section -->
          <templateId extension="2017-08-01" root="2.16.840.1.113883.10.20.24.2.1"/>
          <templateId extension="2017-07-01" root="2.16.840.1.113883.10.20.24.2.1.1"/>
          <code code="55188-7" codeSystem="2.16.840.1.113883.6.1"/>
          <title>Patient Data</title>
          <text/>








            <entry>
              <act classCode="ACT" moodCode="RQO" negationInd="true">
                <templateId root="2.16.840.1.113883.10.20.24.3.130" extension="2017-08-01"/>
                <id root="1.3.6.1.4.1.115" extension="5ba852c059d233049b6f3715"/>
                <code code="SPLY" codeSystem="2.16.840.1.113883.5.6" displayName="Supply" codeSystemName="ActClass"/>
                <entryRelationship typeCode="SUBJ">
                  <supply classCode="SPLY" moodCode="RQO">
                    <!-- Plan of Care Activity Supply -->
                    <templateId root="2.16.840.1.113883.10.20.22.4.43" extension="2014-06-09"/>
                    <!-- Device, Order -->
                    <templateId root="2.16.840.1.113883.10.20.24.3.9" extension="2017-08-01"/>
                    <id root="1.3.6.1.4.1.115" extension="5ba852c059d233049b6f3715"/>
                    <text>Device, Ordered: Intermittent pneumatic compression devices (IPC)</text>
                    <statusCode code="active"/>
                    <author>
                      <templateId root="2.16.840.1.113883.10.20.24.3.155" extension="2017-08-01"/>
                      <time value='20170505120000'/>
                      <assignedAuthor>
                          <id nullFlavor="NA"/>
                      </assignedAuthor>
                    </author>                    <participant typeCode="DEV">
                      <participantRole classCode="MANU">
                        <playingDevice classCode="DEV">
                            <code code="428411000124104" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED-CT"/>
                        </playingDevice>
                      </participantRole>
                    </participant>
                  </supply>
                </entryRelationship>
                <entryRelationship typeCode="RSON">
                  <observation classCode="OBS" moodCode="EVN">
                    <templateId root="2.16.840.1.113883.10.20.24.3.88" extension="2014-12-01"/>
                    <id root="1.3.6.1.4.1.115" extension="a643c410-a1d3-0136-f8ef-0e95690c4dba" />
                    <code code="77301-0" codeSystem="2.16.840.1.113883.6.1" displayName="reason" codeSystemName="LOINC"/>
                    <statusCode code="completed"/>
                    <value code="183932001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED-CT" xsi:type="CD"/>
                  </observation>
                </entryRelationship>                  
              </act>
            </entry>





            <entry>
              <act classCode="ACT" moodCode="EVN">
                <!--Encounter performed Act -->
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                <code code="ENC" codeSystem="2.16.840.1.113883.5.6" codeSystemName="ActClass" displayName="Encounter"/>
                <entryRelationship typeCode="SUBJ">
                  <encounter classCode="ENC" moodCode="EVN">
                    <!--  Encounter activities template -->
                    <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.4.49"/>
                    <!-- Encounter performed template -->
                    <templateId extension="2017-08-01" root="2.16.840.1.113883.10.20.24.3.23"/>
                    <id extension="5ba852c059d233049b6f3714" root="1.3.6.1.4.1.115"/>
                      <code code="32485007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED-CT"/>
                    <text>Encounter, Performed: Encounter Inpatient</text>
                    <statusCode code="completed"/>
                    <effectiveTime><low value='20170505080000'/><high value='20170508111500'/></effectiveTime>
                    <author>
                      <templateId root="2.16.840.1.113883.10.20.24.3.155" extension="2017-08-01"/>
                      <time value='20170505080000'/>
                      <assignedAuthor>
                          <id nullFlavor="NA"/>
                      </assignedAuthor>
                    </author>                      <participant typeCode="LOC">
                        <!-- Facility Location template -->
                        <templateId extension="2017-08-01" root="2.16.840.1.113883.10.20.24.3.100"/>
                        <time>
                          <low value='20170505080000'/><high value='20170508111500'/>
                        </time>
                        <participantRole classCode="SDLOC">
                          <code code="32485007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED-CT"/>
                          <telecom nullFlavor="UNK"/>
                          <playingEntity classCode="PLC">
                            <name/>
                          </playingEntity>
                        </participantRole>
                      </participant>                  </encounter>
                </entryRelationship>
              </act>
            </entry>






            <entry>
              <substanceAdministration classCode="SBADM" moodCode="EVN" negationInd="true">
                <!-- Medication Activity (consolidation) template -->
                <templateId root="2.16.840.1.113883.10.20.22.4.16" extension="2014-06-09"/>
                <!-- Medication, Administered template -->
                <templateId root="2.16.840.1.113883.10.20.24.3.42" extension="2017-08-01"/>
                <id root="1.3.6.1.4.1.115" extension="5ba852c059d233049b6f3716"/>
                <code code="416118004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Administration"/>
                <statusCode code="completed"/>
                <effectiveTime xsi:type="IVL_TS"><low value='20170505120000'/><high nullFlavor='UNK'/></effectiveTime>
                	<doseQuantity nullFlavor="NA"/>
                <consumable>
                  <manufacturedProduct classCode="MANU">
                    <!-- Medication Information (consolidation) template -->
                    <templateId root="2.16.840.1.113883.10.20.22.4.23" extension="2014-06-09"/>
                    <id root="a6451150-a1d3-0136-f8ef-0e95690c4dba"/>
                    <manufacturedMaterial>
                        <code code="861356" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm"/>
                    </manufacturedMaterial>
                  </manufacturedProduct>
                </consumable>
                <author>
                  <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
                  <time value='20170505120000'/>
                  <assignedAuthor>
                      <id nullFlavor="NA"/>
                  </assignedAuthor>
                </author>                <entryRelationship typeCode="RSON">
                  <observation classCode="OBS" moodCode="EVN">
                    <templateId root="2.16.840.1.113883.10.20.24.3.88" extension="2014-12-01"/>
                    <id root="1.3.6.1.4.1.115" extension="a6453bd0-a1d3-0136-f8ef-0e95690c4dba" />
                    <code code="77301-0" codeSystem="2.16.840.1.113883.6.1" displayName="reason" codeSystemName="LOINC"/>
                    <statusCode code="completed"/>
                    <effectiveTime><low value='20170505120000'/><high nullFlavor='UNK'/></effectiveTime>
                    <value code="183932001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED-CT" xsi:type="CD"/>
                  </observation>
                </entryRelationship> 
              </substanceAdministration>
            </entry>






            <entry>
              <procedure classCode="PROC" moodCode="EVN" >
                <!--  Procedure performed template -->
                <templateId root="2.16.840.1.113883.10.20.24.3.64" extension="2017-08-01"/>
                <!-- Procedure Activity Procedure-->
                <templateId root="2.16.840.1.113883.10.20.22.4.14" extension="2014-06-09"/>
                <id root="1.3.6.1.4.1.115" extension="5ba852c059d233049b6f3717"/>
                  <code code="3E030FZ" codeSystem="2.16.840.1.113883.6.4" codeSystemName="ICD-10-PCS">
                  <translation code="50697003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED-CT"/>
                  </code>
                <text>Procedure, Performed: General or Neuraxial Anesthesia</text>
                <statusCode code="completed"/>
                <effectiveTime><low value='20170505090000'/><high value='20170505110000'/></effectiveTime>
                <author>
                  <templateId root="2.16.840.1.113883.10.20.24.3.155" extension="2017-08-01"/>
                  <time value='20170505090000'/>
                  <assignedAuthor>
                      <id nullFlavor="NA"/>
                  </assignedAuthor>
                </author>              </procedure>
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            <entry>
              <procedure classCode="PROC" moodCode="EVN" >
                <!--  Procedure performed template -->
                <templateId root="2.16.840.1.113883.10.20.24.3.64" extension="2017-08-01"/>
                <!-- Procedure Activity Procedure-->
                <templateId root="2.16.840.1.113883.10.20.22.4.14" extension="2014-06-09"/>
                <id root="1.3.6.1.4.1.115" extension="5ba852c059d233049b6f3718"/>
                  <code code="0SRC0JZ" codeSystem="2.16.840.1.113883.6.4" codeSystemName="ICD-10-PCS">
                  <translation code="430698003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED-CT"/>
                  </code>
                <text>Procedure, Performed: Knee Replacement Surgery</text>
                <statusCode code="completed"/>
                <effectiveTime><low value='20170505091500'/><high value='20170505104500'/></effectiveTime>
                <author>
                  <templateId root="2.16.840.1.113883.10.20.24.3.155" extension="2017-08-01"/>
                  <time value='20170505091500'/>
                  <assignedAuthor>
                      <id nullFlavor="NA"/>
                  </assignedAuthor>
                </author>              </procedure>
            </entry>
            

            <entry>
              <!-- Patient Characteristic Payer -->
              <observation classCode="OBS" moodCode="EVN">
                <templateId root="2.16.840.1.113883.10.20.24.3.55"/>
                <id root="a6461cf0-a1d3-0136-f8ef-0e95690c4dba"/> 
                <code code="48768-6" codeSystemName="LOINC" codeSystem="2.16.840.1.113883.6.1" displayName="Payment source"/> 
                <statusCode code="completed"/>
                <effectiveTime><low value='19700101003243'/><high nullFlavor='UNK'/></effectiveTime>
                <value xsi:type="CD" code="2" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" sdtc:valueSet="2.16.840.1.114222.4.11.3591"/>
              </observation>            
            </entry>
        </section>
      </component>
    </structuredBody>
  </component>
</ClinicalDocument>