STU 3 Ballot

This page is part of the FHIR Specification (v1.6.0: STU 3 Ballot 4). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

14.6 Resource Measure - Content

Clinical Quality Information Work GroupMaturity Level: 0Compartments: Not linked to any defined compartments

The Measure resource provides the definition of a quality measure.

14.6.1 Scope and Usage

This resource is a draft proposal for use as part of an approach to Clinical Quality within FHIR, and is documented as part of the Clinical Reasoning module.

The Measure resource represents a structured computable definition of a clinical quality measure. A quality measure is a quantitative tool to assess the performance of an individual or organization with respect to a specified process or outcome via the measurement of actions, processes, or outcomes of clinical care. Quality measures are often derived from clinical quidelines and are designed to determine whether the appropriate care has been provided given a set of clinical criteria and an evidence base.

Note that the Measure itself does not contain any logic; rather a Library resource is referenced that contains the logic required by the measure, and the various expression elements, such as poulation criteria, reference named expressions within that library (or libraries). In addition, if the Measure references multiple libraries, then any expression references within the resource must be qualified with the name of the library that contains the referenced expression.

14.6.2 Boundaries and Relationships

The Measure resource describes a specific quality measure, providing the structure of the measure in terms of the calculation elements (the populations involved). The Group resource is also capable of describing a population, however, the complexity involved in specifying the criteria in the general case requires the use of a high-level query language such as Clinical Quality Language (CQL). As such, the Measure resource defines only the top-level populations and references CQL expressions for the actual criteria.

A Measure is also similar to an Observation resource, with the exception that the Measure is purely definitional, it contains no actual measurements, only a description of how to calculate a particular measurement.

This resource is referenced by measurereport

14.6.3 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure DomainResourceA quality measure definition
... url Σ0..1uriLogical URL to reference this measure
... identifier Σ0..*IdentifierLogical identifier(s) for the measure
... version Σ0..1stringThe version of the measure, if any
... name Σ0..1stringA machine-friendly name for the measure
... title Σ0..1stringA user-friendly title for the measure
... status ?!Σ1..1codedraft | active | inactive
LibraryStatus (Required)
... experimental ?!Σ0..1booleanIf for testing purposes, not real usage
... description 0..1stringNatural language description of the measure
... purpose 0..1stringDescribes the purpose of the measure
... usage 0..1stringDescribes the clinical usage of the measure
... publicationDate 0..1datePublication date for this version of the measure
... lastReviewDate 0..1dateLast review date for the measure
... effectivePeriod 0..1PeriodThe effective date range for the measure
... coverage 0..*UsageContextDescribes the context of use for this measure
... topic 0..*CodeableConceptDescriptional topics for the measure
... contributor 0..*ContributorA content contributor
... publisher 0..1stringName of the publisher (Organization or individual)
... contact 0..*ContactDetailContact details of the publisher
... copyright 0..1stringUse and/or publishing restrictions
... relatedResource 0..*RelatedResourceRelated resources for the measure
... library 0..*Reference(Library)Logic used by the measure
... disclaimer 0..1markdownDisclaimer for the measure
... scoring 0..1codeproportion | ratio | continuous-variable | cohort
MeasureScoring (Required)
... type 0..*codeprocess | outcome
MeasureType (Required)
... riskAdjustment 0..1stringHow is risk adjustment applied for this measure
... rateAggregation 0..1stringHow is rate aggregation performed for this measure
... rationale 0..1markdownWhy does this measure exist
... clinicalRecommendationStatement 0..1markdownClinical recommendation
... improvementNotation 0..1stringImprovement notation for the measure, e.g. higher score indicates better quality
... definition 0..1markdownA natural language definition of the measure
... guidance 0..1markdownThe guidance for the measure
... set 0..1stringThe measure set, e.g. Preventive Care and Screening
... group 0..*BackboneElementPopulation criteria group
.... identifier 1..1IdentifierUnique identifier
.... name 0..1stringShort name
.... description 0..1stringSummary description
.... population 0..*BackboneElementPopulation criteria
..... type 1..1codeinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-score
MeasurePopulationType (Required)
..... identifier 1..1IdentifierUnique identifier
..... name 0..1stringShort name
..... description 0..1stringThe human readable description of this population criteria
..... criteria 1..1stringThe name of a valid referenced CQL expression (may be namespaced) that defines this population criteria
.... stratifier 0..*BackboneElementStratifier criteria for the measure
..... identifier 1..1IdentifierThe identifier for the stratifier used to coordinate the reported data back to this stratifier
..... criteria 0..1stringStratifier criteria
..... path 0..1stringPath to the stratifier
... supplementalData 0..*BackboneElementSupplemental data
.... identifier 1..1IdentifierIdentifier, unique within the measure
.... usage 0..*codesupplemental-data | risk-adjustment-factor
MeasureDataUsage (Required)
.... criteria 0..1stringSupplemental data criteria
.... path 0..1stringPath to the supplemental data element

doco Documentation for this format

UML Diagram (Legend)

Measure (DomainResource)An absolute URL that is used to identify this measure when it is referenced. This SHALL be a URL, SHOULD be globally unique, and SHOULD be an address at which this measure is (or will be) publishedurl : uri [0..1]A logical identifier for the measure such as the CMS or NQF identifier. Note that at least one identifier is required for non-experimental active artifactsidentifier : Identifier [0..*]The version of the measure, if any. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifactsversion : string [0..1]A machine-friendly name for the measure. This name should be usable as an identifier for the measure by machine processing applications such as code generationname : string [0..1]A short, descriptive, user-friendly title for the measuretitle : string [0..1]The status of the measure (this element modifies the meaning of other elements)status : code [1..1] « The status of the measure (Strength=Required)LibraryStatus! »Determines whether the measure was developed for testing purposes (or education/evaluation/marketing), and is not intended to be used in production environments (this element modifies the meaning of other elements)experimental : boolean [0..1]A free text natural language description of the measure from the consumer's perspectivedescription : string [0..1]A brief description of the purpose of the measurepurpose : string [0..1]A detailed description of how the measure is used from a clinical perspectiveusage : string [0..1]The date on which the measure was publishedpublicationDate : date [0..1]The date on which the measure content was last reviewedlastReviewDate : date [0..1]The period during which the measure content is effectiveeffectivePeriod : Period [0..1]Specifies various attributes of the patient population for whom and/or environment of care in which, the measure is applicablecoverage : UsageContext [0..*]Clinical topics related to the content of the measuretopic : CodeableConcept [0..*]A contributor to the content of the measure, including authors, editors, reviewers, and endorserscontributor : Contributor [0..*]The name of the individual or organization that published the measure (also known as the steward for the measure). This information is required for non-experimental active artifactspublisher : string [0..1]Contact details to assist a user in finding and communicating with the publishercontact : ContactDetail [0..*]A copyright statement relating to the measure and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the measurecopyright : string [0..1]Related resources such as additional documentation, justification, or bibliographic referencesrelatedResource : RelatedResource [0..*]A reference to a Library resource containing the formal logic used by the measurelibrary : Reference [0..*] « Library »A disclaimer for the use of the measuredisclaimer : markdown [0..1]The measure scoring type, e.g. proportion, CVscoring : code [0..1] « The scoring type of the measure (Strength=Required)MeasureScoring! »The measure type, e.g. process, outcometype : code [0..*] « The type of measure (Strength=Required)MeasureType! »A description of the risk adjustment factors that may impact the resulting score for the measure and how they may be accounted for when computing and reporting measure resultsriskAdjustment : string [0..1]A description of the rate aggregation for the measurerateAggregation : string [0..1]The rationale for the measurerationale : markdown [0..1]The clinical recommendation statement for the measureclinicalRecommendationStatement : markdown [0..1]Improvement notation for the measure, e.g. higher score indicates better qualityimprovementNotation : string [0..1]A narrative description of the complete measure calculationdefinition : markdown [0..1]Additional guidance for the measure including how it can be used in a clinical context, and the intent of the measureguidance : markdown [0..1]The measure set, e.g. Preventive Care and Screeningset : string [0..1]GroupA unique identifier for the group. This identifier will used to report data for the group in the measure reportidentifier : Identifier [1..1]Optional name or short description of this groupname : string [0..1]The human readable description of this population groupdescription : string [0..1]PopulationThe type of population criteriatype : code [1..1] « The type of population (Strength=Required)MeasurePopulationType! »A unique identifier for the population criteria. This identifier is used to report data against this criteria within the measure reportidentifier : Identifier [1..1]Optional name or short description of this populationname : string [0..1]The human readable description of this population criteriadescription : string [0..1]The name of a valid referenced CQL expression (may be namespaced) that defines this population criteriacriteria : string [1..1]StratifierThe identifier for the stratifier used to coordinate the reported data back to this stratifieridentifier : Identifier [1..1]The criteria for the stratifier. This must be the name of an expression defined within a referenced librarycriteria : string [0..1]The path to an element that defines the stratifier, specified as a valid FHIR resource pathpath : string [0..1]SupplementalDataAn identifier for the supplemental dataidentifier : Identifier [1..1]An indicator of the intended usage for the supplemental data element. Supplemental data indicates the data is additional information requested to augment the measure information. Risk adjustment factor indicates the data is additional information used to calculate risk adjustment factors when applying a risk model to the measure calculationusage : code [0..*] « The intended usage for supplemental data elements in the measure (Strength=Required)MeasureDataUsage! »The criteria for the supplemental data. This must be the name of a valid expression defined within a referenced library, and defines the data to be returned for this elementcriteria : string [0..1]The supplemental data to be supplied as part of the measure response, specified as a valid FHIR Resource Pathpath : string [0..1]A population criteria for the measurepopulation[0..*]The stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library, or a valid FHIR Resource Pathstratifier[0..*]A group of population criteria for the measuregroup[0..*]The supplemental data criteria for the measure report, specified as either the name of a valid CQL expression within a referenced library, or a valid FHIR Resource PathsupplementalData[0..*]

XML Template

<Measure xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <url value="[uri]"/><!-- 0..1 Logical URL to reference this measure -->
 <identifier><!-- 0..* Identifier Logical identifier(s) for the measure --></identifier>
 <version value="[string]"/><!-- 0..1 The version of the measure, if any -->
 <name value="[string]"/><!-- 0..1 A machine-friendly name for the measure -->
 <title value="[string]"/><!-- 0..1 A user-friendly title for the measure -->
 <status value="[code]"/><!-- 1..1 draft | active | inactive -->
 <experimental value="[boolean]"/><!-- 0..1 If for testing purposes, not real usage -->
 <description value="[string]"/><!-- 0..1 Natural language description of the measure -->
 <purpose value="[string]"/><!-- 0..1 Describes the purpose of the measure -->
 <usage value="[string]"/><!-- 0..1 Describes the clinical usage of the measure -->
 <publicationDate value="[date]"/><!-- 0..1 Publication date for this version of the measure -->
 <lastReviewDate value="[date]"/><!-- 0..1 Last review date for the measure -->
 <effectivePeriod><!-- 0..1 Period The effective date range for the measure --></effectivePeriod>
 <coverage><!-- 0..* UsageContext Describes the context of use for this measure --></coverage>
 <topic><!-- 0..* CodeableConcept Descriptional topics for the measure --></topic>
 <contributor><!-- 0..* Contributor A content contributor --></contributor>
 <publisher value="[string]"/><!-- 0..1 Name of the publisher (Organization or individual) -->
 <contact><!-- 0..* ContactDetail Contact details of the publisher --></contact>
 <copyright value="[string]"/><!-- 0..1 Use and/or publishing restrictions -->
 <relatedResource><!-- 0..* RelatedResource Related resources for the measure --></relatedResource>
 <library><!-- 0..* Reference(Library) Logic used by the measure --></library>
 <disclaimer value="[markdown]"/><!-- 0..1 Disclaimer for the measure -->
 <scoring value="[code]"/><!-- 0..1 proportion | ratio | continuous-variable | cohort -->
 <type value="[code]"/><!-- 0..* process | outcome -->
 <riskAdjustment value="[string]"/><!-- 0..1 How is risk adjustment applied for this measure -->
 <rateAggregation value="[string]"/><!-- 0..1 How is rate aggregation performed for this measure -->
 <rationale value="[markdown]"/><!-- 0..1 Why does this measure exist -->
 <clinicalRecommendationStatement value="[markdown]"/><!-- 0..1 Clinical recommendation -->
 <improvementNotation value="[string]"/><!-- 0..1 Improvement notation for the measure, e.g. higher score indicates better quality -->
 <definition value="[markdown]"/><!-- 0..1 A natural language definition of the measure -->
 <guidance value="[markdown]"/><!-- 0..1 The guidance for the measure -->
 <set value="[string]"/><!-- 0..1 The measure set, e.g. Preventive Care and Screening -->
 <group>  <!-- 0..* Population criteria group -->
  <identifier><!-- 1..1 Identifier Unique identifier --></identifier>
  <name value="[string]"/><!-- 0..1 Short name -->
  <description value="[string]"/><!-- 0..1 Summary description -->
  <population>  <!-- 0..* Population criteria -->
   <type value="[code]"/><!-- 1..1 initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-score -->
   <identifier><!-- 1..1 Identifier Unique identifier --></identifier>
   <name value="[string]"/><!-- 0..1 Short name -->
   <description value="[string]"/><!-- 0..1 The human readable description of this population criteria -->
   <criteria value="[string]"/><!-- 1..1 The name of a valid referenced CQL expression (may be namespaced) that defines this population criteria -->
  </population>
  <stratifier>  <!-- 0..* Stratifier criteria for the measure -->
   <identifier><!-- 1..1 Identifier The identifier for the stratifier used to coordinate the reported data back to this stratifier --></identifier>
   <criteria value="[string]"/><!-- 0..1 Stratifier criteria -->
   <path value="[string]"/><!-- 0..1 Path to the stratifier -->
  </stratifier>
 </group>
 <supplementalData>  <!-- 0..* Supplemental data -->
  <identifier><!-- 1..1 Identifier Identifier, unique within the measure --></identifier>
  <usage value="[code]"/><!-- 0..* supplemental-data | risk-adjustment-factor -->
  <criteria value="[string]"/><!-- 0..1 Supplemental data criteria -->
  <path value="[string]"/><!-- 0..1 Path to the supplemental data element -->
 </supplementalData>
</Measure>

JSON Template

{doco
  "resourceType" : "Measure",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "url" : "<uri>", // Logical URL to reference this measure
  "identifier" : [{ Identifier }], // Logical identifier(s) for the measure
  "version" : "<string>", // The version of the measure, if any
  "name" : "<string>", // A machine-friendly name for the measure
  "title" : "<string>", // A user-friendly title for the measure
  "status" : "<code>", // R!  draft | active | inactive
  "experimental" : <boolean>, // If for testing purposes, not real usage
  "description" : "<string>", // Natural language description of the measure
  "purpose" : "<string>", // Describes the purpose of the measure
  "usage" : "<string>", // Describes the clinical usage of the measure
  "publicationDate" : "<date>", // Publication date for this version of the measure
  "lastReviewDate" : "<date>", // Last review date for the measure
  "effectivePeriod" : { Period }, // The effective date range for the measure
  "coverage" : [{ UsageContext }], // Describes the context of use for this measure
  "topic" : [{ CodeableConcept }], // Descriptional topics for the measure
  "contributor" : [{ Contributor }], // A content contributor
  "publisher" : "<string>", // Name of the publisher (Organization or individual)
  "contact" : [{ ContactDetail }], // Contact details of the publisher
  "copyright" : "<string>", // Use and/or publishing restrictions
  "relatedResource" : [{ RelatedResource }], // Related resources for the measure
  "library" : [{ Reference(Library) }], // Logic used by the measure
  "disclaimer" : "<markdown>", // Disclaimer for the measure
  "scoring" : "<code>", // proportion | ratio | continuous-variable | cohort
  "type" : ["<code>"], // process | outcome
  "riskAdjustment" : "<string>", // How is risk adjustment applied for this measure
  "rateAggregation" : "<string>", // How is rate aggregation performed for this measure
  "rationale" : "<markdown>", // Why does this measure exist
  "clinicalRecommendationStatement" : "<markdown>", // Clinical recommendation
  "improvementNotation" : "<string>", // Improvement notation for the measure, e.g. higher score indicates better quality
  "definition" : "<markdown>", // A natural language definition of the measure
  "guidance" : "<markdown>", // The guidance for the measure
  "set" : "<string>", // The measure set, e.g. Preventive Care and Screening
  "group" : [{ // Population criteria group
    "identifier" : { Identifier }, // R!  Unique identifier
    "name" : "<string>", // Short name
    "description" : "<string>", // Summary description
    "population" : [{ // Population criteria
      "type" : "<code>", // R!  initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-score
      "identifier" : { Identifier }, // R!  Unique identifier
      "name" : "<string>", // Short name
      "description" : "<string>", // The human readable description of this population criteria
      "criteria" : "<string>" // R!  The name of a valid referenced CQL expression (may be namespaced) that defines this population criteria
    }],
    "stratifier" : [{ // Stratifier criteria for the measure
      "identifier" : { Identifier }, // R!  The identifier for the stratifier used to coordinate the reported data back to this stratifier
      "criteria" : "<string>", // Stratifier criteria
      "path" : "<string>" // Path to the stratifier
    }]
  }],
  "supplementalData" : [{ // Supplemental data
    "identifier" : { Identifier }, // R!  Identifier, unique within the measure
    "usage" : ["<code>"], // supplemental-data | risk-adjustment-factor
    "criteria" : "<string>", // Supplemental data criteria
    "path" : "<string>" // Path to the supplemental data element
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Measure;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Measure.url [ uri ]; # 0..1 Logical URL to reference this measure
  fhir:Measure.identifier [ Identifier ], ... ; # 0..* Logical identifier(s) for the measure
  fhir:Measure.version [ string ]; # 0..1 The version of the measure, if any
  fhir:Measure.name [ string ]; # 0..1 A machine-friendly name for the measure
  fhir:Measure.title [ string ]; # 0..1 A user-friendly title for the measure
  fhir:Measure.status [ code ]; # 1..1 draft | active | inactive
  fhir:Measure.experimental [ boolean ]; # 0..1 If for testing purposes, not real usage
  fhir:Measure.description [ string ]; # 0..1 Natural language description of the measure
  fhir:Measure.purpose [ string ]; # 0..1 Describes the purpose of the measure
  fhir:Measure.usage [ string ]; # 0..1 Describes the clinical usage of the measure
  fhir:Measure.publicationDate [ date ]; # 0..1 Publication date for this version of the measure
  fhir:Measure.lastReviewDate [ date ]; # 0..1 Last review date for the measure
  fhir:Measure.effectivePeriod [ Period ]; # 0..1 The effective date range for the measure
  fhir:Measure.coverage [ UsageContext ], ... ; # 0..* Describes the context of use for this measure
  fhir:Measure.topic [ CodeableConcept ], ... ; # 0..* Descriptional topics for the measure
  fhir:Measure.contributor [ Contributor ], ... ; # 0..* A content contributor
  fhir:Measure.publisher [ string ]; # 0..1 Name of the publisher (Organization or individual)
  fhir:Measure.contact [ ContactDetail ], ... ; # 0..* Contact details of the publisher
  fhir:Measure.copyright [ string ]; # 0..1 Use and/or publishing restrictions
  fhir:Measure.relatedResource [ RelatedResource ], ... ; # 0..* Related resources for the measure
  fhir:Measure.library [ Reference(Library) ], ... ; # 0..* Logic used by the measure
  fhir:Measure.disclaimer [ markdown ]; # 0..1 Disclaimer for the measure
  fhir:Measure.scoring [ code ]; # 0..1 proportion | ratio | continuous-variable | cohort
  fhir:Measure.type [ code ], ... ; # 0..* process | outcome
  fhir:Measure.riskAdjustment [ string ]; # 0..1 How is risk adjustment applied for this measure
  fhir:Measure.rateAggregation [ string ]; # 0..1 How is rate aggregation performed for this measure
  fhir:Measure.rationale [ markdown ]; # 0..1 Why does this measure exist
  fhir:Measure.clinicalRecommendationStatement [ markdown ]; # 0..1 Clinical recommendation
  fhir:Measure.improvementNotation [ string ]; # 0..1 Improvement notation for the measure, e.g. higher score indicates better quality
  fhir:Measure.definition [ markdown ]; # 0..1 A natural language definition of the measure
  fhir:Measure.guidance [ markdown ]; # 0..1 The guidance for the measure
  fhir:Measure.set [ string ]; # 0..1 The measure set, e.g. Preventive Care and Screening
  fhir:Measure.group [ # 0..* Population criteria group
    fhir:Measure.group.identifier [ Identifier ]; # 1..1 Unique identifier
    fhir:Measure.group.name [ string ]; # 0..1 Short name
    fhir:Measure.group.description [ string ]; # 0..1 Summary description
    fhir:Measure.group.population [ # 0..* Population criteria
      fhir:Measure.group.population.type [ code ]; # 1..1 initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-score
      fhir:Measure.group.population.identifier [ Identifier ]; # 1..1 Unique identifier
      fhir:Measure.group.population.name [ string ]; # 0..1 Short name
      fhir:Measure.group.population.description [ string ]; # 0..1 The human readable description of this population criteria
      fhir:Measure.group.population.criteria [ string ]; # 1..1 The name of a valid referenced CQL expression (may be namespaced) that defines this population criteria
    ], ...;
    fhir:Measure.group.stratifier [ # 0..* Stratifier criteria for the measure
      fhir:Measure.group.stratifier.identifier [ Identifier ]; # 1..1 The identifier for the stratifier used to coordinate the reported data back to this stratifier
      fhir:Measure.group.stratifier.criteria [ string ]; # 0..1 Stratifier criteria
      fhir:Measure.group.stratifier.path [ string ]; # 0..1 Path to the stratifier
    ], ...;
  ], ...;
  fhir:Measure.supplementalData [ # 0..* Supplemental data
    fhir:Measure.supplementalData.identifier [ Identifier ]; # 1..1 Identifier, unique within the measure
    fhir:Measure.supplementalData.usage [ code ], ... ; # 0..* supplemental-data | risk-adjustment-factor
    fhir:Measure.supplementalData.criteria [ string ]; # 0..1 Supplemental data criteria
    fhir:Measure.supplementalData.path [ string ]; # 0..1 Path to the supplemental data element
  ], ...;
]

Changes since DSTU2

This resource did not exist in Release 2

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure DomainResourceA quality measure definition
... url Σ0..1uriLogical URL to reference this measure
... identifier Σ0..*IdentifierLogical identifier(s) for the measure
... version Σ0..1stringThe version of the measure, if any
... name Σ0..1stringA machine-friendly name for the measure
... title Σ0..1stringA user-friendly title for the measure
... status ?!Σ1..1codedraft | active | inactive
LibraryStatus (Required)
... experimental ?!Σ0..1booleanIf for testing purposes, not real usage
... description 0..1stringNatural language description of the measure
... purpose 0..1stringDescribes the purpose of the measure
... usage 0..1stringDescribes the clinical usage of the measure
... publicationDate 0..1datePublication date for this version of the measure
... lastReviewDate 0..1dateLast review date for the measure
... effectivePeriod 0..1PeriodThe effective date range for the measure
... coverage 0..*UsageContextDescribes the context of use for this measure
... topic 0..*CodeableConceptDescriptional topics for the measure
... contributor 0..*ContributorA content contributor
... publisher 0..1stringName of the publisher (Organization or individual)
... contact 0..*ContactDetailContact details of the publisher
... copyright 0..1stringUse and/or publishing restrictions
... relatedResource 0..*RelatedResourceRelated resources for the measure
... library 0..*Reference(Library)Logic used by the measure
... disclaimer 0..1markdownDisclaimer for the measure
... scoring 0..1codeproportion | ratio | continuous-variable | cohort
MeasureScoring (Required)
... type 0..*codeprocess | outcome
MeasureType (Required)
... riskAdjustment 0..1stringHow is risk adjustment applied for this measure
... rateAggregation 0..1stringHow is rate aggregation performed for this measure
... rationale 0..1markdownWhy does this measure exist
... clinicalRecommendationStatement 0..1markdownClinical recommendation
... improvementNotation 0..1stringImprovement notation for the measure, e.g. higher score indicates better quality
... definition 0..1markdownA natural language definition of the measure
... guidance 0..1markdownThe guidance for the measure
... set 0..1stringThe measure set, e.g. Preventive Care and Screening
... group 0..*BackboneElementPopulation criteria group
.... identifier 1..1IdentifierUnique identifier
.... name 0..1stringShort name
.... description 0..1stringSummary description
.... population 0..*BackboneElementPopulation criteria
..... type 1..1codeinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-score
MeasurePopulationType (Required)
..... identifier 1..1IdentifierUnique identifier
..... name 0..1stringShort name
..... description 0..1stringThe human readable description of this population criteria
..... criteria 1..1stringThe name of a valid referenced CQL expression (may be namespaced) that defines this population criteria
.... stratifier 0..*BackboneElementStratifier criteria for the measure
..... identifier 1..1IdentifierThe identifier for the stratifier used to coordinate the reported data back to this stratifier
..... criteria 0..1stringStratifier criteria
..... path 0..1stringPath to the stratifier
... supplementalData 0..*BackboneElementSupplemental data
.... identifier 1..1IdentifierIdentifier, unique within the measure
.... usage 0..*codesupplemental-data | risk-adjustment-factor
MeasureDataUsage (Required)
.... criteria 0..1stringSupplemental data criteria
.... path 0..1stringPath to the supplemental data element

doco Documentation for this format

UML Diagram (Legend)

Measure (DomainResource)An absolute URL that is used to identify this measure when it is referenced. This SHALL be a URL, SHOULD be globally unique, and SHOULD be an address at which this measure is (or will be) publishedurl : uri [0..1]A logical identifier for the measure such as the CMS or NQF identifier. Note that at least one identifier is required for non-experimental active artifactsidentifier : Identifier [0..*]The version of the measure, if any. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifactsversion : string [0..1]A machine-friendly name for the measure. This name should be usable as an identifier for the measure by machine processing applications such as code generationname : string [0..1]A short, descriptive, user-friendly title for the measuretitle : string [0..1]The status of the measure (this element modifies the meaning of other elements)status : code [1..1] « The status of the measure (Strength=Required)LibraryStatus! »Determines whether the measure was developed for testing purposes (or education/evaluation/marketing), and is not intended to be used in production environments (this element modifies the meaning of other elements)experimental : boolean [0..1]A free text natural language description of the measure from the consumer's perspectivedescription : string [0..1]A brief description of the purpose of the measurepurpose : string [0..1]A detailed description of how the measure is used from a clinical perspectiveusage : string [0..1]The date on which the measure was publishedpublicationDate : date [0..1]The date on which the measure content was last reviewedlastReviewDate : date [0..1]The period during which the measure content is effectiveeffectivePeriod : Period [0..1]Specifies various attributes of the patient population for whom and/or environment of care in which, the measure is applicablecoverage : UsageContext [0..*]Clinical topics related to the content of the measuretopic : CodeableConcept [0..*]A contributor to the content of the measure, including authors, editors, reviewers, and endorserscontributor : Contributor [0..*]The name of the individual or organization that published the measure (also known as the steward for the measure). This information is required for non-experimental active artifactspublisher : string [0..1]Contact details to assist a user in finding and communicating with the publishercontact : ContactDetail [0..*]A copyright statement relating to the measure and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the measurecopyright : string [0..1]Related resources such as additional documentation, justification, or bibliographic referencesrelatedResource : RelatedResource [0..*]A reference to a Library resource containing the formal logic used by the measurelibrary : Reference [0..*] « Library »A disclaimer for the use of the measuredisclaimer : markdown [0..1]The measure scoring type, e.g. proportion, CVscoring : code [0..1] « The scoring type of the measure (Strength=Required)MeasureScoring! »The measure type, e.g. process, outcometype : code [0..*] « The type of measure (Strength=Required)MeasureType! »A description of the risk adjustment factors that may impact the resulting score for the measure and how they may be accounted for when computing and reporting measure resultsriskAdjustment : string [0..1]A description of the rate aggregation for the measurerateAggregation : string [0..1]The rationale for the measurerationale : markdown [0..1]The clinical recommendation statement for the measureclinicalRecommendationStatement : markdown [0..1]Improvement notation for the measure, e.g. higher score indicates better qualityimprovementNotation : string [0..1]A narrative description of the complete measure calculationdefinition : markdown [0..1]Additional guidance for the measure including how it can be used in a clinical context, and the intent of the measureguidance : markdown [0..1]The measure set, e.g. Preventive Care and Screeningset : string [0..1]GroupA unique identifier for the group. This identifier will used to report data for the group in the measure reportidentifier : Identifier [1..1]Optional name or short description of this groupname : string [0..1]The human readable description of this population groupdescription : string [0..1]PopulationThe type of population criteriatype : code [1..1] « The type of population (Strength=Required)MeasurePopulationType! »A unique identifier for the population criteria. This identifier is used to report data against this criteria within the measure reportidentifier : Identifier [1..1]Optional name or short description of this populationname : string [0..1]The human readable description of this population criteriadescription : string [0..1]The name of a valid referenced CQL expression (may be namespaced) that defines this population criteriacriteria : string [1..1]StratifierThe identifier for the stratifier used to coordinate the reported data back to this stratifieridentifier : Identifier [1..1]The criteria for the stratifier. This must be the name of an expression defined within a referenced librarycriteria : string [0..1]The path to an element that defines the stratifier, specified as a valid FHIR resource pathpath : string [0..1]SupplementalDataAn identifier for the supplemental dataidentifier : Identifier [1..1]An indicator of the intended usage for the supplemental data element. Supplemental data indicates the data is additional information requested to augment the measure information. Risk adjustment factor indicates the data is additional information used to calculate risk adjustment factors when applying a risk model to the measure calculationusage : code [0..*] « The intended usage for supplemental data elements in the measure (Strength=Required)MeasureDataUsage! »The criteria for the supplemental data. This must be the name of a valid expression defined within a referenced library, and defines the data to be returned for this elementcriteria : string [0..1]The supplemental data to be supplied as part of the measure response, specified as a valid FHIR Resource Pathpath : string [0..1]A population criteria for the measurepopulation[0..*]The stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library, or a valid FHIR Resource Pathstratifier[0..*]A group of population criteria for the measuregroup[0..*]The supplemental data criteria for the measure report, specified as either the name of a valid CQL expression within a referenced library, or a valid FHIR Resource PathsupplementalData[0..*]

XML Template

<Measure xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <url value="[uri]"/><!-- 0..1 Logical URL to reference this measure -->
 <identifier><!-- 0..* Identifier Logical identifier(s) for the measure --></identifier>
 <version value="[string]"/><!-- 0..1 The version of the measure, if any -->
 <name value="[string]"/><!-- 0..1 A machine-friendly name for the measure -->
 <title value="[string]"/><!-- 0..1 A user-friendly title for the measure -->
 <status value="[code]"/><!-- 1..1 draft | active | inactive -->
 <experimental value="[boolean]"/><!-- 0..1 If for testing purposes, not real usage -->
 <description value="[string]"/><!-- 0..1 Natural language description of the measure -->
 <purpose value="[string]"/><!-- 0..1 Describes the purpose of the measure -->
 <usage value="[string]"/><!-- 0..1 Describes the clinical usage of the measure -->
 <publicationDate value="[date]"/><!-- 0..1 Publication date for this version of the measure -->
 <lastReviewDate value="[date]"/><!-- 0..1 Last review date for the measure -->
 <effectivePeriod><!-- 0..1 Period The effective date range for the measure --></effectivePeriod>
 <coverage><!-- 0..* UsageContext Describes the context of use for this measure --></coverage>
 <topic><!-- 0..* CodeableConcept Descriptional topics for the measure --></topic>
 <contributor><!-- 0..* Contributor A content contributor --></contributor>
 <publisher value="[string]"/><!-- 0..1 Name of the publisher (Organization or individual) -->
 <contact><!-- 0..* ContactDetail Contact details of the publisher --></contact>
 <copyright value="[string]"/><!-- 0..1 Use and/or publishing restrictions -->
 <relatedResource><!-- 0..* RelatedResource Related resources for the measure --></relatedResource>
 <library><!-- 0..* Reference(Library) Logic used by the measure --></library>
 <disclaimer value="[markdown]"/><!-- 0..1 Disclaimer for the measure -->
 <scoring value="[code]"/><!-- 0..1 proportion | ratio | continuous-variable | cohort -->
 <type value="[code]"/><!-- 0..* process | outcome -->
 <riskAdjustment value="[string]"/><!-- 0..1 How is risk adjustment applied for this measure -->
 <rateAggregation value="[string]"/><!-- 0..1 How is rate aggregation performed for this measure -->
 <rationale value="[markdown]"/><!-- 0..1 Why does this measure exist -->
 <clinicalRecommendationStatement value="[markdown]"/><!-- 0..1 Clinical recommendation -->
 <improvementNotation value="[string]"/><!-- 0..1 Improvement notation for the measure, e.g. higher score indicates better quality -->
 <definition value="[markdown]"/><!-- 0..1 A natural language definition of the measure -->
 <guidance value="[markdown]"/><!-- 0..1 The guidance for the measure -->
 <set value="[string]"/><!-- 0..1 The measure set, e.g. Preventive Care and Screening -->
 <group>  <!-- 0..* Population criteria group -->
  <identifier><!-- 1..1 Identifier Unique identifier --></identifier>
  <name value="[string]"/><!-- 0..1 Short name -->
  <description value="[string]"/><!-- 0..1 Summary description -->
  <population>  <!-- 0..* Population criteria -->
   <type value="[code]"/><!-- 1..1 initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-score -->
   <identifier><!-- 1..1 Identifier Unique identifier --></identifier>
   <name value="[string]"/><!-- 0..1 Short name -->
   <description value="[string]"/><!-- 0..1 The human readable description of this population criteria -->
   <criteria value="[string]"/><!-- 1..1 The name of a valid referenced CQL expression (may be namespaced) that defines this population criteria -->
  </population>
  <stratifier>  <!-- 0..* Stratifier criteria for the measure -->
   <identifier><!-- 1..1 Identifier The identifier for the stratifier used to coordinate the reported data back to this stratifier --></identifier>
   <criteria value="[string]"/><!-- 0..1 Stratifier criteria -->
   <path value="[string]"/><!-- 0..1 Path to the stratifier -->
  </stratifier>
 </group>
 <supplementalData>  <!-- 0..* Supplemental data -->
  <identifier><!-- 1..1 Identifier Identifier, unique within the measure --></identifier>
  <usage value="[code]"/><!-- 0..* supplemental-data | risk-adjustment-factor -->
  <criteria value="[string]"/><!-- 0..1 Supplemental data criteria -->
  <path value="[string]"/><!-- 0..1 Path to the supplemental data element -->
 </supplementalData>
</Measure>

JSON Template

{doco
  "resourceType" : "Measure",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "url" : "<uri>", // Logical URL to reference this measure
  "identifier" : [{ Identifier }], // Logical identifier(s) for the measure
  "version" : "<string>", // The version of the measure, if any
  "name" : "<string>", // A machine-friendly name for the measure
  "title" : "<string>", // A user-friendly title for the measure
  "status" : "<code>", // R!  draft | active | inactive
  "experimental" : <boolean>, // If for testing purposes, not real usage
  "description" : "<string>", // Natural language description of the measure
  "purpose" : "<string>", // Describes the purpose of the measure
  "usage" : "<string>", // Describes the clinical usage of the measure
  "publicationDate" : "<date>", // Publication date for this version of the measure
  "lastReviewDate" : "<date>", // Last review date for the measure
  "effectivePeriod" : { Period }, // The effective date range for the measure
  "coverage" : [{ UsageContext }], // Describes the context of use for this measure
  "topic" : [{ CodeableConcept }], // Descriptional topics for the measure
  "contributor" : [{ Contributor }], // A content contributor
  "publisher" : "<string>", // Name of the publisher (Organization or individual)
  "contact" : [{ ContactDetail }], // Contact details of the publisher
  "copyright" : "<string>", // Use and/or publishing restrictions
  "relatedResource" : [{ RelatedResource }], // Related resources for the measure
  "library" : [{ Reference(Library) }], // Logic used by the measure
  "disclaimer" : "<markdown>", // Disclaimer for the measure
  "scoring" : "<code>", // proportion | ratio | continuous-variable | cohort
  "type" : ["<code>"], // process | outcome
  "riskAdjustment" : "<string>", // How is risk adjustment applied for this measure
  "rateAggregation" : "<string>", // How is rate aggregation performed for this measure
  "rationale" : "<markdown>", // Why does this measure exist
  "clinicalRecommendationStatement" : "<markdown>", // Clinical recommendation
  "improvementNotation" : "<string>", // Improvement notation for the measure, e.g. higher score indicates better quality
  "definition" : "<markdown>", // A natural language definition of the measure
  "guidance" : "<markdown>", // The guidance for the measure
  "set" : "<string>", // The measure set, e.g. Preventive Care and Screening
  "group" : [{ // Population criteria group
    "identifier" : { Identifier }, // R!  Unique identifier
    "name" : "<string>", // Short name
    "description" : "<string>", // Summary description
    "population" : [{ // Population criteria
      "type" : "<code>", // R!  initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-score
      "identifier" : { Identifier }, // R!  Unique identifier
      "name" : "<string>", // Short name
      "description" : "<string>", // The human readable description of this population criteria
      "criteria" : "<string>" // R!  The name of a valid referenced CQL expression (may be namespaced) that defines this population criteria
    }],
    "stratifier" : [{ // Stratifier criteria for the measure
      "identifier" : { Identifier }, // R!  The identifier for the stratifier used to coordinate the reported data back to this stratifier
      "criteria" : "<string>", // Stratifier criteria
      "path" : "<string>" // Path to the stratifier
    }]
  }],
  "supplementalData" : [{ // Supplemental data
    "identifier" : { Identifier }, // R!  Identifier, unique within the measure
    "usage" : ["<code>"], // supplemental-data | risk-adjustment-factor
    "criteria" : "<string>", // Supplemental data criteria
    "path" : "<string>" // Path to the supplemental data element
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Measure;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Measure.url [ uri ]; # 0..1 Logical URL to reference this measure
  fhir:Measure.identifier [ Identifier ], ... ; # 0..* Logical identifier(s) for the measure
  fhir:Measure.version [ string ]; # 0..1 The version of the measure, if any
  fhir:Measure.name [ string ]; # 0..1 A machine-friendly name for the measure
  fhir:Measure.title [ string ]; # 0..1 A user-friendly title for the measure
  fhir:Measure.status [ code ]; # 1..1 draft | active | inactive
  fhir:Measure.experimental [ boolean ]; # 0..1 If for testing purposes, not real usage
  fhir:Measure.description [ string ]; # 0..1 Natural language description of the measure
  fhir:Measure.purpose [ string ]; # 0..1 Describes the purpose of the measure
  fhir:Measure.usage [ string ]; # 0..1 Describes the clinical usage of the measure
  fhir:Measure.publicationDate [ date ]; # 0..1 Publication date for this version of the measure
  fhir:Measure.lastReviewDate [ date ]; # 0..1 Last review date for the measure
  fhir:Measure.effectivePeriod [ Period ]; # 0..1 The effective date range for the measure
  fhir:Measure.coverage [ UsageContext ], ... ; # 0..* Describes the context of use for this measure
  fhir:Measure.topic [ CodeableConcept ], ... ; # 0..* Descriptional topics for the measure
  fhir:Measure.contributor [ Contributor ], ... ; # 0..* A content contributor
  fhir:Measure.publisher [ string ]; # 0..1 Name of the publisher (Organization or individual)
  fhir:Measure.contact [ ContactDetail ], ... ; # 0..* Contact details of the publisher
  fhir:Measure.copyright [ string ]; # 0..1 Use and/or publishing restrictions
  fhir:Measure.relatedResource [ RelatedResource ], ... ; # 0..* Related resources for the measure
  fhir:Measure.library [ Reference(Library) ], ... ; # 0..* Logic used by the measure
  fhir:Measure.disclaimer [ markdown ]; # 0..1 Disclaimer for the measure
  fhir:Measure.scoring [ code ]; # 0..1 proportion | ratio | continuous-variable | cohort
  fhir:Measure.type [ code ], ... ; # 0..* process | outcome
  fhir:Measure.riskAdjustment [ string ]; # 0..1 How is risk adjustment applied for this measure
  fhir:Measure.rateAggregation [ string ]; # 0..1 How is rate aggregation performed for this measure
  fhir:Measure.rationale [ markdown ]; # 0..1 Why does this measure exist
  fhir:Measure.clinicalRecommendationStatement [ markdown ]; # 0..1 Clinical recommendation
  fhir:Measure.improvementNotation [ string ]; # 0..1 Improvement notation for the measure, e.g. higher score indicates better quality
  fhir:Measure.definition [ markdown ]; # 0..1 A natural language definition of the measure
  fhir:Measure.guidance [ markdown ]; # 0..1 The guidance for the measure
  fhir:Measure.set [ string ]; # 0..1 The measure set, e.g. Preventive Care and Screening
  fhir:Measure.group [ # 0..* Population criteria group
    fhir:Measure.group.identifier [ Identifier ]; # 1..1 Unique identifier
    fhir:Measure.group.name [ string ]; # 0..1 Short name
    fhir:Measure.group.description [ string ]; # 0..1 Summary description
    fhir:Measure.group.population [ # 0..* Population criteria
      fhir:Measure.group.population.type [ code ]; # 1..1 initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-score
      fhir:Measure.group.population.identifier [ Identifier ]; # 1..1 Unique identifier
      fhir:Measure.group.population.name [ string ]; # 0..1 Short name
      fhir:Measure.group.population.description [ string ]; # 0..1 The human readable description of this population criteria
      fhir:Measure.group.population.criteria [ string ]; # 1..1 The name of a valid referenced CQL expression (may be namespaced) that defines this population criteria
    ], ...;
    fhir:Measure.group.stratifier [ # 0..* Stratifier criteria for the measure
      fhir:Measure.group.stratifier.identifier [ Identifier ]; # 1..1 The identifier for the stratifier used to coordinate the reported data back to this stratifier
      fhir:Measure.group.stratifier.criteria [ string ]; # 0..1 Stratifier criteria
      fhir:Measure.group.stratifier.path [ string ]; # 0..1 Path to the stratifier
    ], ...;
  ], ...;
  fhir:Measure.supplementalData [ # 0..* Supplemental data
    fhir:Measure.supplementalData.identifier [ Identifier ]; # 1..1 Identifier, unique within the measure
    fhir:Measure.supplementalData.usage [ code ], ... ; # 0..* supplemental-data | risk-adjustment-factor
    fhir:Measure.supplementalData.criteria [ string ]; # 0..1 Supplemental data criteria
    fhir:Measure.supplementalData.path [ string ]; # 0..1 Path to the supplemental data element
  ], ...;
]

Changes since DSTU2

This resource did not exist in Release 2

 

Alternate definitions: Master Definition (XML, JSON), XML Schema/Schematron (for ) + JSON Schema, ShEx (for Turtle)

14.6.3.1 Terminology Bindings

PathDefinitionTypeReference
Measure.status The status of the measureRequiredLibraryStatus
Measure.scoring The scoring type of the measureRequiredMeasureScoring
Measure.type The type of measureRequiredMeasureType
Measure.group.population.type The type of populationRequiredMeasurePopulationType
Measure.supplementalData.usage The intended usage for supplemental data elements in the measureRequiredMeasureDataUsage

14.6.4 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionPaths
descriptionstringText search against the descriptionMeasure.description
identifiertokenLogical identifier for the module (e.g. CMS-143)Measure.identifier
statustokenStatus of the moduleMeasure.status
titlestringText search against the titleMeasure.title
topictokenTopics associated with the moduleMeasure.topic
versionstringVersion of the module (e.g. 1.0.0)Measure.version