CDC NHSN Situational Awareness Framework for Reporting (NHSN SAFR) Content Implementation Guide
1.0.0 - STU 1.0.0 United States of America flag

This page is part of the NHSN Situational Awareness Framework for Reporting (NHSN SAFR) Implementation Guide (v1.0.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

An important objective in the NHSN Situational Awareness Framework for Reporting (NHSN SAFR) IG is to avoid unnecessary profile proliferation and to leverage common processes. To this end the IG leverages the profiles, extensions and operations incorporated into the US Situational Awareness Framework for Reporting (US SAFR) Implementation Guide.

Behavior: Capability Statements

The following artifacts define the specific capabilities that different types of systems are expected to have in order to comply with this implementation guide. Systems conforming to this implementation guide are expected to declare conformance to one or more of the following capability statements.

Title Description
NHSN SAFR Data Aggregator CapabilityStatement

This statement defines the expected capabilities of a system that aggregates data from multiple Data Source actors before measure evaluation and then plays the role of a Data Source once aggregation is complete. An example would be a state public health agency aggregating data from all facilities in the state before using those data to produce a MeasureReport containing bed capacity data for the entire state. When FHIR enabled, a Data Aggregator acts as a US Core Server when playing the role of a Data Source after aggregation. During aggregation, the Data Aggregator acts similar to the SANER options for aggregation, but implements its own CapabilityStatement due to the incompatibilities between DEQM and SANER.

NHSN SAFR Data Evaluation Engine CapabilityStatement

This statement defines the expected capabilities of a system that retrieves data from the Data Source and evaluates those data against one or more measures retrieved from the Measure Source. The resulting MeasureReport bundle and related resources are then sent to the MeasureReport recipient. The Measure Evaluation Engine acts as a US Core Client, a DEQM Reporter Client, and implements the $evaluation-measure operation. Note: FHIR queries are not always required. In the case, an EHR retrieves data from it's own internal data store using non-FHIR methods or imports data from other systems that are not FHIR-enabled.

NHSN SAFR Data Source CapabilityStatement

This statement defines the expected capabilities of a system containing data (typically patient data, but could be situational awareness data) that will be evaluated against one or more measures. This may be a FHIR server, an EHR with a FHIR endpoint (facade), an internal data store when the Data Source and Measure Evaluation Engine actors are played by the same system such as an EHR that does it’s own measure evaluation, or it may be a system containing other data such as situational awareness data that is reporting via CSV or other format. When FHIR enabled, the Data Source acts as a US Core Server. Note: US Core Server is only needed for external evaluation engines. Examples of where this is not needed, is an EHR querying it's own data source using proprietary data access methods.

NHSN SAFR Measure Source CapabilityStatement

This statement defines the expected capabilities of a system at NHSN, federal and jurisdictional Public Health Agencies including State, Tribal, Local and Territorial (STLT) Health Departments that stores FHIR resources such as Measure, Library, ValueSet, etc. that are used for Measure Reporting. The Measure Evaluation Engine queries the Measure Source for the latest Measure content before querying the Patient Data Source and performing measure evaluation. The Measure Source acts as a CQFM Publishable Measure Repository.

NHSN SAFR MeasureReport Recipient CapabilityStatement

This statement defines the expected capabilities of a system at NHSN, federal and jurisdictional Public Health Agencies including State, Tribal, Local and Territorial (STLT) Health Departments that receives MeasureReport bundles from the Measure Evaluation Engine and validates the result against the profiles in this implementation guide, and potentially other measure-specific profiles that are distributed with the measures themselves. The MeasureReport Recipient acts as a DEQM Receiver Server, provides write access to Bundle resources containing MeasureReport and other related resources, and implements the $validate operation.

Knowledge Artifacts: Measure

These define measures as part of content in this implementation guide.

Title Description
Bed Capacity Measure

Bed Capacity Measure includes counts of specific bed types within the context of a given healthcare context or setting.

HRD Measure

Hospital Respiratory Data Measure

Knowledge Artifacts: Libraries

These define logic, asset collections and other libraries as part of content in this implementation guide.

Title Description
BedCapacityMeasure

Library containing the Bed Capacity Measure.

FHIR Helpers

This library defines functions to convert between FHIR data types and CQL system-defined types, as well as functions to support FHIRPath implementation. For more information, the FHIRHelpers wiki page: https://github.com/cqframework/clinical_quality_language/wiki/FHIRHelpers. This locally defined version includes modifications from the original library.

HRDMeasure

Library for the Hospital Respiratory Data (HRD) Measure.

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

Title Description
NHSN SAFR HRD Supply Day Time Period Ranges Value Set

HRD Supply Day Time Period Ranges value set using codes from ISO 8601 for expressing time period ranges.

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

Title Description
Healthcare Bed Capacity Reporting Code System

This CodeSystem defines coded concepts for Healthcare Capacity reporting for NHSN SAFR.

Hospital Respiratory Data Reporting Code System

This CodeSystem defines coded concepts for Hospital Respiratory Data reporting for NHSN SAFR.

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

Title Description
Bundle - Bed Capacity Report Bundle Example

Bundle containing a measure report and all referenced resources for NHSN bed capacity reporting.

Bundle - HRD Measure Report Bundle Example

Bundle containing a measure report and all referenced resources for NHSN Hospital Respiratory Disease (HRD) reporting

Bundle - NHSN SAFR Measure Bundle Example

Bundle containing a measure for NHSN reporting.

Children's Bed 4

A bed located in the Children's Department of the hospital.

Emergency Dept. Bed 1

A bed located in the Emergency Department.

Encounter - Example ED Patient 1 - Emergency

Encounter - Example ED Patient 1 - Emergency department visit

Inpatient Psychiatric Bed 3

A bed located in the Inpatient Psychiatric Department of the hospital.

Inpatient Rehabilitation Bed 2

A bed located in Inpatient Rehabilitation department of the hospital.

Intensive Care Unit Bed 6

A bed located in the ICU Unit of the hospital.

Location - Hospital Facility Example

Example of a Hospital Facility for NHSN reporting.

MeasureReport - Bed Capacity MeasureReport Example

Example MeasureReport for NHSN bed capacity monitoring showing ICU, ED, and Pediatric bed capacity

MeasureReport - HRD MeasureReport Example

This Bundle resource is an example of a Hospital Respiratory Data (HRD) MeasureReport.

Organization - Submitting Hospital Organization Example

Organization - Example of a Submitting Hospital Organization

Other Facility Bed 3

A bed located in an subunit of the facility.

Patient - Example ED Patient 1

Example ED Patient 1 is a patient who has been seen in the emergency department.

Pediatric Bed 7

A bed located in the Pediatrics Unit of the hospital.

Other

These are resources that are used within this implementation guide that do not fit into one of the other categories.

Title Description
CQL Testing Tooling

This Device resource is used to represent the CQL tooling software. It is referenced by the Library resources to indicate that the CQL tooling used to execute the CQL in those libraries.