Communication

Communication represents the transmission, receipt, or acknowledgement of information sent from a source to a recipient, such as from one clinician to another regarding findings, assessments, plans of care, consultative advice, instructions, and educational resources. The HL7 FHIR 3.0 resource Communication defines communication as a conveyance of information from one entity, a sender, to another entity, a receiver. The senders and receivers may be patients, practitioners, care partners, organizations, or devices. Established FHIR resources include:

• A reminder or alert delivered to a responsible provider
• A recorded notification from the nurse that a patient's temperature exceeds a value
• A notification to a public health agency of a patient presenting with a communicable disease reportable to the public health agency
• Patient educational material sent by a provider to a patient
• Non-patient specific communication use cases may include:
• A nurse call from a hall bathroom
• Advisory for battery service from a pump

Generally, direct patient counseling, training or education represents an intervention or procedure. A time and a date stamp are required.
QDM through version 5.3 included three communication QDM datatypes:

• "Communication, Provider to Patient"
• "Communication, Patient to Provider"
• "Communication, Provider to Provider"

These three datatypes restricted the measure developer to communication between patients and providers and among providers. The structure of the datatypes also provided implicit guidance to implementers to define what type of provider based on the intent of the measure.
QDM 5.4 merged the three communication QDM datatypes into one, "Communication, Performed" to allow greater expressivity and more explicit definition of the sender and receiver and to indicate the anticipated communication medium. This new QDM modeling is more consistent with other QDM datatypes and it is also modeled more consistently with existing communication interoperability resources (e.g., HL7 FHIR). Note that measure developers need to test measures that use "Communication, Performed" to determine if the sender and recipient attribute information is available. Confirmation regarding receipt of communications requires interoperability.