Overview

The content of The Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) Digital Quality Measures (dQMs) Content Package Implementation Guide (IG) defines the standards for reporting the initial population and supplemental data elements needed for calculating metrics for the CDC NHSN dQMs Content Package IG. This IG does not define how to calculate a specific NHSN dQM or event of interest.

This IG complies with the NHSN dQM Reporting IG, published by Health Level Seven International (HL7®) International for general requirements for submissions to NHSN. The NHSN dQM Reporting IG specifications will be revised in accordance with any changes to NHSN reporting requirements. The figure below shows how the CDC NHSN dQM IG fits into the broader landscape of HL7 FHIR and NHSN IGs.

Figure 1 shows how different guidance documents and measure definitions relate to one another within CDC’s NHSN digital quality measurement framework.

On the left side, three stacked labels represent the sources that NHSN’s digital measures rely on:

• HL7 Balloted Framework IGs- National HL7 implementation guides that provide the foundational FHIR structures.
• NHSN Content Package IGs- NHSN-specific implementation guides that define measure profiles and logic.
• NHSN Protocols and Metrics- Clinical protocols and specifications that determine the measure requirements.

Across the top of the figure, the header reads “Surveillance and Quality Measurement.”

The top green box shows the HL7 NHSN dQM Reporting IG, which establishes the general framework for how digital quality measures are reported.

Below it, the lighter green box shows the CDC NHSN dQM IG, which contains two groups of measure profiles and their associated CQL logic:

• ACH Monthly Profiles and CQL
• ACH Daily Profiles and CQL

Within this content package, several NHSN measure concepts are displayed, including:

• Glycemic Control
• Adult Sepsis
• Bacteremia and Fungemia
• C. difficile Infection
• Respiratory Pathogens Surveillance (RPS)

At the bottom of the figure, a horizontal label reads “Patient-level Data,” indicating that all parts of the framework ultimately depend on patient-level information for reporting.

All of the measure reporting artifacts and profiles contained in the ultimately relate to patient-level data extraction, representation, and submission for quality measurement.

Purpose

These specifications define the data content requirements for submissions for the CDC NHSN dQMs Content Package to NHSN through NHSNLink.

Relationships to Other Standards

This IG has the following dependencies:

1. HL7 FHIR Release 4
2. US Core 6.1.0
3. US Core 3.1.1
4. QI Core 6.0.0
5. HL7 NHSN dQM 1.0.0
6. HL7 CRMI 1.0.0
7. Quality Measure IG 5.0.0
8. Clinical Quality Framework Common FHIR Assets 4.0.1
9. Data Exchange for Quality Measures (DEQM) 5.0.0

Audience

The audience for this work is all developers who want to enable their software systems to report surveillance data to the NHSN via FHIR dQMs.

Acknowledgements

Lantana Consulting Group, Inc. produced and developed the content in this IG under contract to the Division of Healthcare Quality Promotion (DHQP) in the National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) at the Centers for Disease Control and Prevention (CDC).

Role	Name	Organization	Email Address
Primary Editor	Rick Geimer	Lantana Consulting Group	rick.geimer@lantanagroup.com
Primary Editor	Corey Spears	Lantana Consulting Group	corey.spears@lantanagroup.com
Primary Editor	Aaron Nusstein	Lantana Consulting Group	aaron.nusstein@lantanagroup.com
Co-Editor	Andrea Benin	CDC	aqb4@cdc.gov
Co-Editor	Kristina Betz	CDC	rly7@cdc.gov
Co-Editor	Amrit Kerr	Lantana Consulting Group	amrit.kerr@lantanagroup.com
Co-Editor	Sheila Abner	CDC	sha8@cdc.gov
Co-Editor	Nadine Shehab	Lantana Consulting Group	ftn0@cdc.gov
Co-Editor	Jennifer Watkins	CACI	nub7@cdc.gov
Co-Editor	Raymond Dantes	CDC	vic5@cdc.gov
Co-Editor	David deRoode	Lantana Consulting Group	david.deroode@lantanagroup.com
Co-Editor	Zabrina Gonzaga	Lantana Consulting Group	zabrina.gonzaga@lantanagroup.com
Co-Editor	Sean McIlvenna	Lantana Consulting Group	sean.mcilvenna@lantanagroup.com
Co-Editor	Lynn Perrine	Lantana Consulting Group	lynn.perrine@lantanagroup.com
Co-Editor	Kim Figueroa	Lantana Consulting Group	kim.figueroa@lantanagroup.com
Co-Editor	Mary-Margaret Richter	Lantana Consulting Group	mm.richter@lantanagroup.com
Co-Editor	Shanai Thornton	Lantana Consulting Group	shanai.thornton@lantanagroup.com