From acc22fe44daf0679e887d92e152ac174c2dc7738 Mon Sep 17 00:00:00 2001
From: Evan Chicoine <evan.chicoine@esacinc.com>
Date: Tue, 3 Sep 2024 18:35:08 -0400
Subject: [PATCH 1/2] Re-ran qi-core script with file creation.

---
 ...tureDefinition-qicore-keyelement-intro.xml | 16 +++++++++
 ...on-qicore-nonpatient-observation-intro.xml | 36 +++++++++++++++++++
 2 files changed, 52 insertions(+)
 create mode 100644 input/intro-notes/StructureDefinition-qicore-keyelement-intro.xml
 create mode 100644 input/intro-notes/StructureDefinition-qicore-nonpatient-observation-intro.xml

diff --git a/input/intro-notes/StructureDefinition-qicore-keyelement-intro.xml b/input/intro-notes/StructureDefinition-qicore-keyelement-intro.xml
new file mode 100644
index 00000000..f2e6ef87
--- /dev/null
+++ b/input/intro-notes/StructureDefinition-qicore-keyelement-intro.xml
@@ -0,0 +1,16 @@
+<!--Begin Generated Intro Tag (DO NOT REMOVE)-->
+<br></br>
+<b>NOTE TO BALLOT REVIEWERS:</b>
+<ul>
+<li>US Core 7.0, and thus QI-Core 7.0, has a new approach to USCDI requirements.</li>
+<ul>
+<li>As noted in the US Core 7.0 <a href='https://hl7.org/fhir/us/core/must-support.html#must-support-elements'>Must Support</a> section, US Core 7.0 no longer highlights mandatory (cardinality 1..* or 1..1) and Must Support elements with a (USCDI) indicator as such items must be supported for interoperability.</li>
+<li>Those USCDI elements that are not mandatory or Must Support now include an indicator (ADDITIONAL USCDI) in US Core. QI-Core 7.0 does not reference USCDI elements; rather, users should access US Core 7.0 to understand its implementation of USCDI version 4.</li>
+</ul>
+<li>We invite comments about the approach and suggestions for other options that would also avoid unnecessary noise or reading load to the QI-Core profile representation.</li>
+<li>Further, QI-Core 7.0 does not discuss <a href='https://uscdiplus.healthit.gov/uscdi'>USCDI+Quality</a> because at the time of ballot preparation, no published version of USCDI+Quality is available. We seek reviewer advice regarding how QI-Core might address future USCDI+Quality.</li>
+</ul>
+<br></br>
+
+
+<!--End Generated Intro (DO NOT REMOVE)-->
diff --git a/input/intro-notes/StructureDefinition-qicore-nonpatient-observation-intro.xml b/input/intro-notes/StructureDefinition-qicore-nonpatient-observation-intro.xml
new file mode 100644
index 00000000..e90e590f
--- /dev/null
+++ b/input/intro-notes/StructureDefinition-qicore-nonpatient-observation-intro.xml
@@ -0,0 +1,36 @@
+<!--Begin Generated Intro Tag (DO NOT REMOVE)-->
+<b>QI Elements:</b>
+<ul>
+<li>status: (QI) registered | prliminary | final | amended | corrected | entered-in-error | unknown</li>
+<li>category: (QI) Classification of type of observation</li>
+<li>code: (QI) Type of observation (code / type)</li>
+<li>subject: (QI) The device/location/implantable device the observation is about</li>
+<li>effective[x]: (QI) Clinically relevant time/time-period for observation</li>
+<li>performer: (QI) Who is responsible for the observation</li>
+<li>value[x]: (QI) Actual result</li>
+<li>value[x]: (QI) actual | potential</li>
+<li>interpretation: (QI) High, low, normal, etc.</li>
+<li>derivedFrom: (QI) QI Core Profiles or other resource the observation is made from</li>
+</ul>
+
+<b>Primary code path:</b> code
+<br></br>
+(PCPath) This element is the primary code path for this resource <a href='https://cql.hl7.org/02-authorsguide.html#filtering-with-terminology'>CQL Retrieve</a>
+<br></br>
+<br></br>
+
+<br></br>
+<b>NOTE TO BALLOT REVIEWERS:</b>
+<ul>
+<li>US Core 7.0, and thus QI-Core 7.0, has a new approach to USCDI requirements.</li>
+<ul>
+<li>As noted in the US Core 7.0 <a href='https://hl7.org/fhir/us/core/must-support.html#must-support-elements'>Must Support</a> section, US Core 7.0 no longer highlights mandatory (cardinality 1..* or 1..1) and Must Support elements with a (USCDI) indicator as such items must be supported for interoperability.</li>
+<li>Those USCDI elements that are not mandatory or Must Support now include an indicator (ADDITIONAL USCDI) in US Core. QI-Core 7.0 does not reference USCDI elements; rather, users should access US Core 7.0 to understand its implementation of USCDI version 4.</li>
+</ul>
+<li>We invite comments about the approach and suggestions for other options that would also avoid unnecessary noise or reading load to the QI-Core profile representation.</li>
+<li>Further, QI-Core 7.0 does not discuss <a href='https://uscdiplus.healthit.gov/uscdi'>USCDI+Quality</a> because at the time of ballot preparation, no published version of USCDI+Quality is available. We seek reviewer advice regarding how QI-Core might address future USCDI+Quality.</li>
+</ul>
+<br></br>
+
+
+<!--End Generated Intro (DO NOT REMOVE)-->

From fbb383cd864fb0cd80fbb7a384ada44a6f190ca3 Mon Sep 17 00:00:00 2001
From: Evan Chicoine <evan.chicoine@esacinc.com>
Date: Tue, 24 Sep 2024 15:43:53 -0400
Subject: [PATCH 2/2] Re-ran script with file creation turned on.

---
 ...StructureDefinition-qicore-claim-intro.xml |  5 ++++
 ...tion-qicore-communicationnotdone-intro.xml |  2 +-
 ...nition-qicore-devicenotrequested-intro.xml |  2 +-
 ...ition-qicore-immunizationnotdone-intro.xml |  2 +-
 ...-qicore-medicationadministration-intro.xml |  1 +
 ...-medicationadministrationnotdone-intro.xml |  2 +-
 ...nition-qicore-medicationdispense-intro.xml |  1 +
 ...efinition-qicore-observation-lab-intro.xml |  1 +
 ...tion-qicore-observationcancelled-intro.xml |  2 +-
 ...finition-qicore-procedurenotdone-intro.xml |  2 ++
 ...eDefinition-qicore-relatedperson-intro.xml |  1 +
 ...ition-qicore-servicenotrequested-intro.xml |  2 --
 input/pages/qi-elements.md                    | 23 +++++++++++++------
 13 files changed, 32 insertions(+), 14 deletions(-)

diff --git a/input/intro-notes/StructureDefinition-qicore-claim-intro.xml b/input/intro-notes/StructureDefinition-qicore-claim-intro.xml
index 4803a474..428836bc 100644
--- a/input/intro-notes/StructureDefinition-qicore-claim-intro.xml
+++ b/input/intro-notes/StructureDefinition-qicore-claim-intro.xml
@@ -2,15 +2,20 @@
 <!--Begin Generated Intro Tag (DO NOT REMOVE)-->
 <b>QI Elements:</b>
 <ul>
+<li>Claim: Claim, Pre-determination or Pre-authorization</li>
 <li>patient: (QI) The recipient of the products and services</li>
 <li>billablePeriod: (QI) Relevant time frame for the claim</li>
 <li>created: (QI) Resource creation date</li>
 <li>provider: (QI) Party responsible for the claim</li>
 <li>prescription: (QI) Prescription authorizing services and products</li>
+<li>diagnosis: (QI) Pertinent diagnosis information</li>
 <li>diagnosis.sequence: (QI) Diagnosis instance identifier</li>
 <li>diagnosis.diagnosis[x]: (QI) Nature of illness or problem</li>
+<li>diagnosis.type: (QI) Timing or nature of the diagnosis</li>
 <li>diagnosis.onAdmission: (QI) Present on admission</li>
+<li>procedure: (QI) Clinical procedures performed</li>
 <li>procedure.sequence: (QI) Procedure instance identifier</li>
+<li>procedure.type: (QI) Category of Procedure</li>
 <li>procedure.procedure[x]: (QI) Specific clinical procedure</li>
 <li>item.encounter: (QI) Encounters related to this billed item</li>
 </ul>
diff --git a/input/intro-notes/StructureDefinition-qicore-communicationnotdone-intro.xml b/input/intro-notes/StructureDefinition-qicore-communicationnotdone-intro.xml
index 6e09a687..c7409263 100644
--- a/input/intro-notes/StructureDefinition-qicore-communicationnotdone-intro.xml
+++ b/input/intro-notes/StructureDefinition-qicore-communicationnotdone-intro.xml
@@ -2,7 +2,7 @@
 <!--Begin Generated Intro Tag (DO NOT REMOVE)-->
 <b>QI Elements:</b>
 <ul>
-<li>recorded: (QI) Extension</li>
+<li>event-recorded: (QI) Captures the recorded date of the communication</li>
 <li>status: (QI) preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown</li>
 <li>statusReason: (QI) Reason for current status</li>
 <li>subject: (QI) Focus of message</li>
diff --git a/input/intro-notes/StructureDefinition-qicore-devicenotrequested-intro.xml b/input/intro-notes/StructureDefinition-qicore-devicenotrequested-intro.xml
index 720d867b..d62ac2fd 100644
--- a/input/intro-notes/StructureDefinition-qicore-devicenotrequested-intro.xml
+++ b/input/intro-notes/StructureDefinition-qicore-devicenotrequested-intro.xml
@@ -2,7 +2,6 @@
 <!--Begin Generated Intro Tag (DO NOT REMOVE)-->
 <b>QI Elements:</b>
 <ul>
-<li>doNotPerformReason: (QI) Extension</li>
 <li>modifierExtension: (QI) Extension</li>
 <li>modifierExtension.value[x]: (QI) Value of extension</li>
 <li>status: (QI) draft | active | on-hold | revoked | completed | entered-in-error | unknown</li>
@@ -11,6 +10,7 @@
 <li>doNotPerformValueSet: (QI) What was not done</li>
 <li>subject: (QI) Focus of request</li>
 <li>authoredOn: (QI) When recorded</li>
+<li>reasonCode: (QI) Explanation/Justification for procedure or service</li>
 </ul>
 
 <b>Primary code path:</b> code
diff --git a/input/intro-notes/StructureDefinition-qicore-immunizationnotdone-intro.xml b/input/intro-notes/StructureDefinition-qicore-immunizationnotdone-intro.xml
index 4d5d02b5..0ac7f7b7 100644
--- a/input/intro-notes/StructureDefinition-qicore-immunizationnotdone-intro.xml
+++ b/input/intro-notes/StructureDefinition-qicore-immunizationnotdone-intro.xml
@@ -12,7 +12,7 @@
 <b>QI Elements:</b>
 <ul>
 <li>notDoneValueSet: (QI) What wasn't administered</li>
-<li>recorded: (QI) When the immunization was first captured in the subject's record</li>
+<li>recorded: (QI) Documented date Immunization did not occur.</li>
 </ul>
 
 <b>Primary code path:</b> vaccineCode
diff --git a/input/intro-notes/StructureDefinition-qicore-medicationadministration-intro.xml b/input/intro-notes/StructureDefinition-qicore-medicationadministration-intro.xml
index bcc145ea..701d0f20 100644
--- a/input/intro-notes/StructureDefinition-qicore-medicationadministration-intro.xml
+++ b/input/intro-notes/StructureDefinition-qicore-medicationadministration-intro.xml
@@ -2,6 +2,7 @@
 <!--Begin Generated Intro Tag (DO NOT REMOVE)-->
 <b>QI Elements:</b>
 <ul>
+<li>recorded: (QI) Recorded</li>
 <li>status: (QI) in-progress | on-hold | completed | entered-in-error | stopped | unknown</li>
 <li>medication[x]: (QI) What was administered</li>
 <li>subject: (QI) Who received medication</li>
diff --git a/input/intro-notes/StructureDefinition-qicore-medicationadministrationnotdone-intro.xml b/input/intro-notes/StructureDefinition-qicore-medicationadministrationnotdone-intro.xml
index 69293999..1364b01f 100644
--- a/input/intro-notes/StructureDefinition-qicore-medicationadministrationnotdone-intro.xml
+++ b/input/intro-notes/StructureDefinition-qicore-medicationadministrationnotdone-intro.xml
@@ -3,7 +3,7 @@
 <b>QI Elements:</b>
 <ul>
 <li>implicitRules: (QI) A set of rules under which this content was created</li>
-<li>recorded: (QI) Extension</li>
+<li>recorded: (QI) Recorded</li>
 <li>status: (QI) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown</li>
 <li>statusReason: (QI) Reason administration not performed</li>
 <li>medication[x]: (QI) What was administered</li>
diff --git a/input/intro-notes/StructureDefinition-qicore-medicationdispense-intro.xml b/input/intro-notes/StructureDefinition-qicore-medicationdispense-intro.xml
index 2e744ba5..0f2b1ef2 100644
--- a/input/intro-notes/StructureDefinition-qicore-medicationdispense-intro.xml
+++ b/input/intro-notes/StructureDefinition-qicore-medicationdispense-intro.xml
@@ -10,6 +10,7 @@
 
 <b>QI Elements:</b>
 <ul>
+<li>recorded: (QI) Extension</li>
 <li>authorizingPrescription: (QI) Medication order that authorizes the dispense</li>
 <li>type: (QI) Trial fill, partial fill, emergency fill, etc.</li>
 <li>quantity: (QI) Amount dispensed</li>
diff --git a/input/intro-notes/StructureDefinition-qicore-observation-lab-intro.xml b/input/intro-notes/StructureDefinition-qicore-observation-lab-intro.xml
index edcad3c8..147f460f 100644
--- a/input/intro-notes/StructureDefinition-qicore-observation-lab-intro.xml
+++ b/input/intro-notes/StructureDefinition-qicore-observation-lab-intro.xml
@@ -11,6 +11,7 @@
 
 <b>QI Elements:</b>
 <ul>
+<li>encounter: (QI) Encounter associated with Observation</li>
 <li>effective[x]: (QI) Clinically relevant time/time-period for observation</li>
 <li>issued: (QI) Date/Time this version was made available</li>
 <li>value[x]: (QI) Result Value</li>
diff --git a/input/intro-notes/StructureDefinition-qicore-observationcancelled-intro.xml b/input/intro-notes/StructureDefinition-qicore-observationcancelled-intro.xml
index 78ec9ffb..f4251544 100644
--- a/input/intro-notes/StructureDefinition-qicore-observationcancelled-intro.xml
+++ b/input/intro-notes/StructureDefinition-qicore-observationcancelled-intro.xml
@@ -2,7 +2,7 @@
 <!--Begin Generated Intro Tag (DO NOT REMOVE)-->
 <b>QI Elements:</b>
 <ul>
-<li>notDoneReason: (QI) Extension</li>
+<li>event-statusReason: (QI) Event Status Reason</li>
 <li>status: (QI) registered | preliminary | final | amended +</li>
 <li>category: (QI) Classification of type of observation</li>
 <li>code: (QI) Type of observation (code / type)</li>
diff --git a/input/intro-notes/StructureDefinition-qicore-procedurenotdone-intro.xml b/input/intro-notes/StructureDefinition-qicore-procedurenotdone-intro.xml
index 0740d341..8d46379d 100644
--- a/input/intro-notes/StructureDefinition-qicore-procedurenotdone-intro.xml
+++ b/input/intro-notes/StructureDefinition-qicore-procedurenotdone-intro.xml
@@ -14,6 +14,8 @@
 <li>statusReason: (QI) Reason for the current status</li>
 <li>notDoneValueSet: (QI) What was not performed</li>
 <li>performed[x]: (QI) When the procedure was performed</li>
+<li>reasonCode: (QI) Coded reason procedure performed</li>
+<li>reasonReference: (QI) The justification that the procedure was performed</li>
 </ul>
 
 <b>Primary code path:</b> code
diff --git a/input/intro-notes/StructureDefinition-qicore-relatedperson-intro.xml b/input/intro-notes/StructureDefinition-qicore-relatedperson-intro.xml
index 0ad9a77a..faafb2d5 100644
--- a/input/intro-notes/StructureDefinition-qicore-relatedperson-intro.xml
+++ b/input/intro-notes/StructureDefinition-qicore-relatedperson-intro.xml
@@ -10,6 +10,7 @@
 <ul>
 <li>relationship: (QI) The nature of the relationship</li>
 <li>name: (QI) A name associated with the person</li>
+<li>telecom: (QI) A contact detail for the person</li>
 </ul>
 
 <b>Primary code path:</b> relationship
diff --git a/input/intro-notes/StructureDefinition-qicore-servicenotrequested-intro.xml b/input/intro-notes/StructureDefinition-qicore-servicenotrequested-intro.xml
index de08d0cb..31decc92 100644
--- a/input/intro-notes/StructureDefinition-qicore-servicenotrequested-intro.xml
+++ b/input/intro-notes/StructureDefinition-qicore-servicenotrequested-intro.xml
@@ -11,8 +11,6 @@
 
 <b>QI Elements:</b>
 <ul>
-<li>reasonRefused: (QI) Extension</li>
-<li>doNotPerform: (QI) True if service/procedure should not be performed</li>
 <li>notDoneValueSet: (QI) What was not requested</li>
 <li>occurrence[x]: (QI) When service should occur</li>
 <li>reasonCode: (QI) Explanation/Justification for procedure or service</li>
diff --git a/input/pages/qi-elements.md b/input/pages/qi-elements.md
index 1839835c..ce75ca79 100644
--- a/input/pages/qi-elements.md
+++ b/input/pages/qi-elements.md
@@ -105,15 +105,20 @@
 
 ### [QICore Claim](StructureDefinition-qicore-claim.html) ###
 **QI Elements:**
+* Claim: Claim, Pre-determination or Pre-authorization
 * patient: (QI) The recipient of the products and services
 * billablePeriod: (QI) Relevant time frame for the claim
 * created: (QI) Resource creation date
 * provider: (QI) Party responsible for the claim
 * prescription: (QI) Prescription authorizing services and products
+* diagnosis: (QI) Pertinent diagnosis information
 * diagnosis.sequence: (QI) Diagnosis instance identifier
 * diagnosis.diagnosis[x]: (QI) Nature of illness or problem
+* diagnosis.type: (QI) Timing or nature of the diagnosis
 * diagnosis.onAdmission: (QI) Present on admission
+* procedure: (QI) Clinical procedures performed
 * procedure.sequence: (QI) Procedure instance identifier
+* procedure.type: (QI) Category of Procedure
 * procedure.procedure[x]: (QI) Specific clinical procedure
 * item.encounter: (QI) Encounters related to this billed item
 
@@ -155,7 +160,7 @@
 
 ### [QICore Communication Not Done](StructureDefinition-qicore-communicationnotdone.html) ###
 **QI Elements:**
-* recorded: (QI) Extension
+* event-recorded: (QI) Captures the recorded date of the communication
 * status: (QI) preparation \| in-progress \| not-done \| on-hold \| stopped \| completed \| entered-in-error \| unknown
 * statusReason: (QI) Reason for current status
 * subject: (QI) Focus of message
@@ -290,7 +295,6 @@
 
 ### [QICore Device Not Requested](StructureDefinition-qicore-devicenotrequested.html) ###
 **QI Elements:**
-* doNotPerformReason: (QI) Extension
 * modifierExtension: (QI) Extension
 * modifierExtension.value[x]: (QI) Value of extension
 * status: (QI) draft \| active \| on-hold \| revoked \| completed \| entered-in-error \| unknown
@@ -299,6 +303,7 @@
 * doNotPerformValueSet: (QI) What was not done
 * subject: (QI) Focus of request
 * authoredOn: (QI) When recorded
+* reasonCode: (QI) Explanation/Justification for procedure or service
 
 **Primary code path:** code
 <br>
@@ -537,7 +542,7 @@
 
 **QI Elements:**
 * notDoneValueSet: (QI) What wasn't administered
-* recorded: (QI) When the immunization was first captured in the subject's record
+* recorded: (QI) Documented date Immunization did not occur.
 
 **Primary code path:** vaccineCode
 <br>
@@ -619,6 +624,7 @@
 
 
 **QI Elements:**
+* encounter: (QI) Encounter associated with Observation
 * effective[x]: (QI) Clinically relevant time/time-period for observation
 * issued: (QI) Date/Time this version was made available
 * value[x]: (QI) Result Value
@@ -698,7 +704,7 @@
 ### [QICore MedicationAdministration Not Done](StructureDefinition-qicore-medicationadministrationnotdone.html) ###
 **QI Elements:**
 * implicitRules: (QI) A set of rules under which this content was created
-* recorded: (QI) Extension
+* recorded: (QI) Recorded
 * status: (QI) in-progress \| not-done \| on-hold \| completed \| entered-in-error \| stopped \| unknown
 * statusReason: (QI) Reason administration not performed
 * medication[x]: (QI) What was administered
@@ -720,6 +726,7 @@
 
 ### [QICore MedicationAdministration](StructureDefinition-qicore-medicationadministration.html) ###
 **QI Elements:**
+* recorded: (QI) Recorded
 * status: (QI) in-progress \| on-hold \| completed \| entered-in-error \| stopped \| unknown
 * medication[x]: (QI) What was administered
 * subject: (QI) Who received medication
@@ -777,6 +784,7 @@
 
 
 **QI Elements:**
+* recorded: (QI) Extension
 * authorizingPrescription: (QI) Medication order that authorizes the dispense
 * type: (QI) Trial fill, partial fill, emergency fill, etc.
 * quantity: (QI) Amount dispensed
@@ -902,7 +910,7 @@
 
 ### [QICore Observation Cancelled](StructureDefinition-qicore-observationcancelled.html) ###
 **QI Elements:**
-* notDoneReason: (QI) Extension
+* event-statusReason: (QI) Event Status Reason
 * status: (QI) registered \| preliminary \| final \| amended +
 * category: (QI) Classification of type of observation
 * code: (QI) Type of observation (code / type)
@@ -1099,6 +1107,8 @@
 * statusReason: (QI) Reason for the current status
 * notDoneValueSet: (QI) What was not performed
 * performed[x]: (QI) When the procedure was performed
+* reasonCode: (QI) Coded reason procedure performed
+* reasonReference: (QI) The justification that the procedure was performed
 
 **Primary code path:** code
 <br>
@@ -1163,6 +1173,7 @@
 **QI Elements:**
 * relationship: (QI) The nature of the relationship
 * name: (QI) A name associated with the person
+* telecom: (QI) A contact detail for the person
 
 **Primary code path:** relationship
 <br>
@@ -1184,8 +1195,6 @@
 
 
 **QI Elements:**
-* reasonRefused: (QI) Extension
-* doNotPerform: (QI) True if service/procedure should not be performed
 * notDoneValueSet: (QI) What was not requested
 * occurrence[x]: (QI) When service should occur
 * reasonCode: (QI) Explanation/Justification for procedure or service