Fhir 40675 consider adding annotation capability from risk adjustment to the individual measure report

input/ig.json

@@ -1136,6 +1136,12 @@
                     "reference": "ValueSet/update-type"
                 }
             },
+            {
+                "exampleBoolean": false,
+                "reference": {
+                    "reference": "StructureDefinition/extension-careGapRemark"
+                }
+            },
             {
                 "exampleBoolean": false,
                 "reference": {

input/oids.ini

@@ -7,9 +7,9 @@ information5 = (b) you can change the oid of the resource to an OID you assign m
 information6 = There is never a reason to edit anything else
 
 [Key]
-CodeSystem = 3
-ValueSet = 3
-StructureDefinition = 31
+CodeSystem = 5
+ValueSet = 5
+StructureDefinition = 32
 OperationDefinition = 5
 CapabilityStatement = 8
 Library = 4
@@ -19,11 +19,15 @@ Measure = 6
 care-gap-reason = 2.16.840.1.113883.4.642.40.2.16.1
 gaps-status = 2.16.840.1.113883.4.642.40.2.16.2
 update-type = 2.16.840.1.113883.4.642.40.2.16.3
+care-gap-remark = 2.16.840.1.113883.4.642.40.23.16.4
+remark-reason = 2.16.840.1.113883.4.642.40.23.16.5
 
 [ValueSet]
 care-gap-reason = 2.16.840.1.113883.4.642.40.2.48.1
 gaps-status = 2.16.840.1.113883.4.642.40.2.48.2
 update-type = 2.16.840.1.113883.4.642.40.2.48.3
+care-gap-remark = 2.16.840.1.113883.4.642.40.23.48.4
+remark-reason = 2.16.840.1.113883.4.642.40.23.48.5
 
 [StructureDefinition]
 cqf-denominatorMembership = 2.16.840.1.113883.4.642.40.2.42.1
@@ -57,6 +61,7 @@ reasonDetail = 2.16.840.1.113883.4.642.40.2.42.28
 subjectlist-measurereport-deqm = 2.16.840.1.113883.4.642.40.2.42.29
 summary-measurereport-deqm = 2.16.840.1.113883.4.642.40.2.42.30
 measurereport-supplementalData = 2.16.840.1.113883.4.642.40.23.42.31
+extension-careGapRemark = 2.16.840.1.113883.4.642.40.23.42.32
 
 [OperationDefinition]
 bulk-submit-data = 2.16.840.1.113883.4.642.40.2.33.1

input/pagecontent/change-notes.md

@@ -5,6 +5,7 @@ The Data Exchange For Quality Measures Implementation Guide was developed under
 
 1. Applied the following trackers:
    - DEQM STU5 Final Publication: Build QA #1 (individual measure report errors)([CQF-2428](https://icf.atlassian.net/browse/CQF-2428))([Applied here](StructureDefinition-indv-measurereport-deqm.html))
+   - Consider adding Annotation capability from Risk Adjustment to the Individual MeasureReport([FHIR-40675](https://jira.hl7.org/browse/FHIR-40675)) Applied ([here](StructureDefinition-extension-careGapRemark.html)), ([here](CodeSystem-care-gap-remark.html)), ([here](ValueSet-care-gap-remark.html)), ([here](CodeSystem-remark-reason.html)), ([here](ValueSet-remark-reason.html)), ([here](ig.json)), ([here](gaps-in-care-reporting.html)), and ([here](StructureDefinition-indv-measurereport-deqm.html))
 
 ### Changes and Updates for STU5 Ballot for 2024Sept Version of the DEQM IG.
 

input/pagecontent/gaps-in-care-reporting.md

@@ -150,6 +150,16 @@ Example Business Use Cases:
 
 By incorporating the [Detailed Care Gap Guidance Response profile](StructureDefinition-gaps-guidanceresponse-detailedcaregap.html), healthcare organizations can receive tailored and actionable guidance on addressing specific care gaps. The inclusion of `reasonCode` and `dataRequirement` enables standardized categorization, context-specific recommendations, and ensures a more focused approach to quality improvement efforts.
 
+#### Add Remark to Gaps in Care Report
+{:.no_toc}
+
+Note to Balloters: We are actively seeking input on [remark codes](CodeSystem-care-gap-remark.html), the [remark value set](ValueSet-care-gap-remark.html), and the remark workflow.
+{:.note-to-balloters}
+
+When considering a Gaps in Care Report, a provider may add remarks using the [Care Gap Remark](StructureDefinition-extension-careGapRemark.html) extension.  The remark can be free-text or a remark code.
+
+See the Condition Category Remark section of the [Risk Adjustment IG](https://build.fhir.org/ig/HL7/davinci-ra/cc-remark.html) for related usage.
+
 #### Attribution
 {:.no_toc}
 

input/resources/CodeSystem-care-gap-remark.json

@@ -0,0 +1,56 @@
+{
+  "resourceType": "CodeSystem",
+  "status": "active",
+  "content": "complete",
+  "name": "CareGapRemark",
+  "id": "care-gap-remark",
+  "title": "Care Gap Remark Code System",
+  "version": "1.0.0",
+  "url": "http://hl7.org/fhir/us/davinci-deqm/CodeSystem/care-gap-remark",
+  "experimental": false,
+  "description": "This is a code system for Care Gap Remark",
+  "caseSensitive": true,
+  "concept": [
+    {
+      "code": "order-placed",
+      "display": "Order placed",
+      "definition": "An order has been placed to address and close the gap"
+    },
+    {
+      "code": "satisfied-in-EHR",
+      "display": "Satisfied in EHR",
+      "definition": "Data already present in the EHR satisfies the open gap."
+    },
+    {
+      "code": "out-of-range",
+      "display": "Out of range",
+      "definition": "EHR reports patient condition is not within allowed threshold."
+    },
+    {
+      "code": "patient-refused",
+      "display": "Patient refused",
+      "definition": "Patient refused intervention to close the gap."
+    },
+    {
+      "code": "rejected",
+      "display": "Rejected",
+      "definition": "Action to address the gap was rejected by the provider."
+    },
+    {
+      "code": "suppressed",
+      "display": "Suppressed",
+      "definition": "Presentation of the gap to the provider was suppressed."
+    },
+    {
+      "code": "not-assessed",
+      "display": "Not assessed",
+      "definition": "Gap was shown to the provider but no action was taken to assess the gap."
+    },
+    {
+      "code": "not-ingested",
+      "display": "Not ingested",
+      "definition": "System cannot process the gap that was received."
+    }
+  ],
+  "count": 8
+}

input/resources/CodeSystem-remark-reason.json

@@ -0,0 +1,21 @@
+{
+  "resourceType": "CodeSystem",
+  "id": "remark-reason",
+  "url": "http://hl7.org/fhir/us/davinci-deqm/CodeSystem/remark-reason",
+  "name": "RemarkReason",
+  "title": "Remark Reason CodeSystem",
+  "status": "active",
+  "experimental": false,
+  "description": "Reason codes for remark",
+  "caseSensitive": true,
+  "valueSet": "http://hl7.org/fhir/us/davinci-deqm/ValueSet/remark-reason",
+  "content": "complete",
+  "concept": [
+    {
+      "code": "inapplicable-gap",
+      "display": "Inapplicable gap",
+      "definition": "Reason for the remark is because the gap is not applicable to the patient."
+    }
+  ],
+  "count": 1
+}