R4 Ballot #1 (Mixed Normative/Trial use)

This page is part of the FHIR Specification (v3.3.0: R4 Ballot 2). 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

14.11 Resource Measure - Content

Clinical Quality Information Work GroupMaturity Level: 2 Trial Use Compartments: Not linked to any defined compartments

The Measure resource provides the definition of a quality measure.

14.11.1 Scope and Usage

This resource is a definition resource from a FHIR workflow perspective - see Workflow, specifically Definition.

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 guidelines 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 population 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.

14.11.2 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.

A Measure is also similar to a clinical document, but as with the relationship to Observation, a Document is specific to a particular subject.

This resource is referenced by measurereport

14.11.3 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure TUDomainResourceA quality measure definition
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... url Σ0..1uriCanonical identifier for this measure, represented as a URI (globally unique)
... identifier Σ0..*IdentifierAdditional identifier for the measure
... version Σ0..1stringBusiness version of the measure
... name Σ0..1stringName for this measure (computer friendly)
... title Σ0..1stringName for this measure (human friendly)
... subtitle 0..1stringSubordinate title of the measure
... status ?!Σ1..1codedraft | active | retired | unknown
PublicationStatus (Required)
... experimental ?!Σ0..1booleanFor testing purposes, not real usage
... subject[x] 0..1E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
SubjectType (Extensible)
.... subjectCodeableConceptCodeableConcept
.... subjectReferenceReference(Group)
... date Σ0..1dateTimeDate last changed
... publisher Σ0..1stringName of the publisher (organization or individual)
... contact Σ0..*ContactDetailContact details for the publisher
... description Σ0..1markdownNatural language description of the measure
... useContext Σ0..*UsageContextThe context that the content is intended to support
... jurisdiction Σ0..*CodeableConceptIntended jurisdiction for measure (if applicable)
Jurisdiction ValueSet (Extensible)
... purpose 0..1markdownWhy this measure is defined
... usage 0..1stringDescribes the clinical usage of the measure
... copyright 0..1markdownUse and/or publishing restrictions
... approvalDate 0..1dateWhen the measure was approved by publisher
... lastReviewDate 0..1dateWhen the measure was last reviewed
... effectivePeriod Σ0..1PeriodWhen the measure is expected to be used
... topic 0..*CodeableConceptThe category of the measure, such as Education, Treatment, Assessment, etc.
DefinitionTopic (Example)
... contributor 0..*ContributorA content contributor
... relatedArtifact 0..*RelatedArtifactAdditional documentation, citations, etc.
... library 0..*canonicalLogic used by the measure
... disclaimer Σ0..1markdownDisclaimer for use of the measure or its referenced content
... scoring Σ0..1CodeableConceptproportion | ratio | continuous-variable | cohort
MeasureScoring (Extensible)
... compositeScoring Σ0..1CodeableConceptopportunity | all-or-nothing | linear | weighted
CompositeMeasureScoring (Extensible)
... type Σ0..*CodeableConceptprocess | outcome | structure | patient-reported-outcome | composite
MeasureType (Extensible)
... riskAdjustment Σ0..1stringHow risk adjustment is applied for this measure
... rateAggregation Σ0..1stringHow is rate aggregation performed for this measure
... rationale Σ0..1markdownWhy does this measure exist
... clinicalRecommendationStatement Σ0..1markdownSummary of clinical guidelines
... improvementNotation Σ0..1stringImprovement notation for the measure, e.g. higher score indicates better quality
... definition Σ0..*markdownDefined terms used in the measure documentation
... guidance Σ0..1markdownAdditional guidance for implementers
... set Σ0..1stringThe measure set, e.g. Preventive Care and Screening
... group 0..*BackboneElementPopulation criteria group
.... code 0..1CodeableConceptMeaning of the group
.... description 0..1stringSummary description
.... population 0..*BackboneElementPopulation criteria
..... code 0..1CodeableConceptinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
MeasurePopulationType (Extensible)
..... 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
..... code 0..1CodeableConceptMeaning of the stratifier
..... description 0..1stringThe human readable description of this stratifier
..... criteria 0..1stringHow the measure should be stratified
..... path 0..1stringPath to the stratifier
... supplementalData 0..*BackboneElementWhat other data should be reported with the measure
.... code 0..1CodeableConceptMeaning of the supplemental data
.... usage 0..*CodeableConceptsupplemental-data | risk-adjustment-factor
MeasureDataUsage (Extensible)
.... description 0..1stringThe human readable description of this supplemental data
.... criteria 0..1stringExpression describing additional data to be reported
.... path 0..1stringPath to the supplemental data element

doco Documentation for this format

UML Diagram (Legend)

Measure (DomainResource)An absolute URI that is used to identify this measure when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which this measure is (or will be) publishedurl : uri [0..1]A formal identifier that is used to identify this measure when it is represented in other formats, or referenced in a specification, model, design or an instanceidentifier : Identifier [0..*]The identifier that is used to identify this version of the measure when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the measure author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. 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 natural language name identifying the measure. This name should be usable as an identifier for the module by machine processing applications such as code generationname : string [0..1]A short, descriptive, user-friendly title for the measuretitle : string [0..1]An explanatory or alternate title for the measure giving additional information about its contentsubtitle : string [0..1]The status of this measure. Enables tracking the life-cycle of the content (this element modifies the meaning of other elements)status : code [1..1] « The lifecycle status of an artifact. (Strength=Required)PublicationStatus! »A Boolean value to indicate that this measure is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage (this element modifies the meaning of other elements)experimental : boolean [0..1]The intended subjects for the measure. If this element is not provided, a Patient subject is assumed, but the subject of the measure can be anythingsubject[x] : Type [0..1] « CodeableConcept|Reference(Group); The possible types of subjects for a measure (E.g. Patient, Practitioner, Organization, Location, etc.) (Strength=Extensible) SubjectType+ »The date (and optionally time) when the measure was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the measure changesdate : dateTime [0..1]The name of the organization or individual that published the measurepublisher : string [0..1]Contact details to assist a user in finding and communicating with the publishercontact : ContactDetail [0..*]A free text natural language description of the measure from a consumer's perspectivedescription : markdown [0..1]The content was developed with a focus and intent of supporting the contexts that are listed. These terms may be used to assist with indexing and searching for appropriate measure instancesuseContext : UsageContext [0..*]A legal or geographic region in which the measure is intended to be usedjurisdiction : CodeableConcept [0..*] « Countries and regions within which this artifact is targeted for use (Strength=Extensible)Jurisdiction ValueSet+ »Explanation of why this measure is needed and why it has been designed as it haspurpose : markdown [0..1]A detailed description, from a clinical perspective, of how the measure is usedusage : string [0..1]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 : markdown [0..1]The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usageapprovalDate : date [0..1]The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval datelastReviewDate : date [0..1]The period during which the measure content was or is planned to be in active useeffectivePeriod : Period [0..1]Descriptive topics related to the content of the measure. Topics provide a high-level categorization grouping types of measures that can be useful for filtering and searchingtopic : CodeableConcept [0..*] « High-level categorization of the definition, used for searching, sorting, and filtering (Strength=Example)DefinitionTopic?? »A contributor to the content of the measure, including authors, editors, reviewers, and endorserscontributor : Contributor [0..*]Related artifacts such as additional documentation, justification, or bibliographic referencesrelatedArtifact : RelatedArtifact [0..*]A reference to a Library resource containing the formal logic used by the measurelibrary : canonical [0..*]Notices and disclaimers regarding the use of the measure or related to intellectual property (such as code systems) referenced by the measuredisclaimer : markdown [0..1]Indicates how the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort. The value set is extensible, allowing additional measure scoring types to be representedscoring : CodeableConcept [0..1] « The scoring type of the measure (Strength=Extensible)MeasureScoring+ »If this is a composite measure, the scoring method used to combine the component measures to determine the composite scorecompositeScoring : CodeableConcept [0..1] « The composite scoring method of the measure (Strength=Extensible)CompositeMeasureScoring+ »Indicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilizationtype : CodeableConcept [0..*] « The type of measure (includes codes from 2.16.840.1.113883.1.11.20368) (Strength=Extensible)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]Describes how to combine the information calculated, based on logic in each of several populations, into one summarized resultrateAggregation : string [0..1]Provides a succinct statement of the need for the measure. Usually includes statements pertaining to importance criterion: impact, gap in care, and evidencerationale : markdown [0..1]Provides a summary of relevant clinical guidelines or other clinical recommendations supporting the measureclinicalRecommendationStatement : markdown [0..1]Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range)improvementNotation : string [0..1]Provides a description of an individual term used within the measuredefinition : markdown [0..*]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]GroupIndicates a meaning for the group. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing groups to be correlated across measurescode : CodeableConcept [0..1]The human readable description of this population groupdescription : string [0..1]PopulationThe type of population criteriacode : CodeableConcept [0..1] « The type of population (Strength=Extensible)MeasurePopulationType+ »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]StratifierIndicates a meaning for the stratifier. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing stratifiers to be correlated across measurescode : CodeableConcept [0..1]The human readable description of this stratifier criteriadescription : string [0..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]SupplementalDataIndicates a meaning for the supplemental data. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing supplemental data to be correlated across measurescode : CodeableConcept [0..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 : CodeableConcept [0..*] « The intended usage for supplemental data elements in the measure (Strength=Extensible)MeasureDataUsage+ »The human readable description of this supplemental datadescription : string [0..1]The criteria for the supplemental data. This must be the name of a valid expression defined within a referenced library. The criteria 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 Canonical identifier for this measure, represented as a URI (globally unique) -->
 <identifier><!-- 0..* Identifier Additional identifier for the measure --></identifier>
 <version value="[string]"/><!-- 0..1 Business version of the measure -->
 <name value="[string]"/><!-- 0..1 Name for this measure (computer friendly) -->
 <title value="[string]"/><!-- 0..1 Name for this measure (human friendly) -->
 <subtitle value="[string]"/><!-- 0..1 Subordinate title of the measure -->
 <status value="[code]"/><!-- 1..1 draft | active | retired | unknown -->
 <experimental value="[boolean]"/><!-- 0..1 For testing purposes, not real usage -->
 <subject[x]><!-- 0..1 CodeableConcept|Reference(Group) E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device --></subject[x]>
 <date value="[dateTime]"/><!-- 0..1 Date last changed -->
 <publisher value="[string]"/><!-- 0..1 Name of the publisher (organization or individual) -->
 <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact>
 <description value="[markdown]"/><!-- 0..1 Natural language description of the measure -->
 <useContext><!-- 0..* UsageContext The context that the content is intended to support --></useContext>
 <jurisdiction><!-- 0..* CodeableConcept Intended jurisdiction for measure (if applicable) --></jurisdiction>
 <purpose value="[markdown]"/><!-- 0..1 Why this measure is defined -->
 <usage value="[string]"/><!-- 0..1 Describes the clinical usage of the measure -->
 <copyright value="[markdown]"/><!-- 0..1 Use and/or publishing restrictions -->
 <approvalDate value="[date]"/><!-- 0..1 When the measure was approved by publisher -->
 <lastReviewDate value="[date]"/><!-- 0..1 When the measure was last reviewed -->
 <effectivePeriod><!-- 0..1 Period When the measure is expected to be used --></effectivePeriod>
 <topic><!-- 0..* CodeableConcept The category of the measure, such as Education, Treatment, Assessment, etc. --></topic>
 <contributor><!-- 0..* Contributor A content contributor --></contributor>
 <relatedArtifact><!-- 0..* RelatedArtifact Additional documentation, citations, etc. --></relatedArtifact>
 <library><!-- 0..* canonical(Library) Logic used by the measure --></library>
 <disclaimer value="[markdown]"/><!-- 0..1 Disclaimer for use of the measure or its referenced content -->
 <scoring><!-- 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort --></scoring>
 <compositeScoring><!-- 0..1 CodeableConcept opportunity | all-or-nothing | linear | weighted --></compositeScoring>
 <type><!-- 0..* CodeableConcept process | outcome | structure | patient-reported-outcome | composite --></type>
 <riskAdjustment value="[string]"/><!-- 0..1 How risk adjustment is 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 Summary of clinical guidelines -->
 <improvementNotation value="[string]"/><!-- 0..1 Improvement notation for the measure, e.g. higher score indicates better quality -->
 <definition value="[markdown]"/><!-- 0..* Defined terms used in the measure documentation -->
 <guidance value="[markdown]"/><!-- 0..1 Additional guidance for implementers -->
 <set value="[string]"/><!-- 0..1 The measure set, e.g. Preventive Care and Screening -->
 <group>  <!-- 0..* Population criteria group -->
  <code><!-- 0..1 CodeableConcept Meaning of the group --></code>
  <description value="[string]"/><!-- 0..1 Summary description -->
  <population>  <!-- 0..* Population criteria -->
   <code><!-- 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation --></code>
   <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 -->
   <code><!-- 0..1 CodeableConcept Meaning of the stratifier --></code>
   <description value="[string]"/><!-- 0..1 The human readable description of this stratifier -->
   <criteria value="[string]"/><!-- 0..1 How the measure should be stratified -->
   <path value="[string]"/><!-- 0..1 Path to the stratifier -->
  </stratifier>
 </group>
 <supplementalData>  <!-- 0..* What other data should be reported with the measure -->
  <code><!-- 0..1 CodeableConcept Meaning of the supplemental data --></code>
  <usage><!-- 0..* CodeableConcept supplemental-data | risk-adjustment-factor --></usage>
  <description value="[string]"/><!-- 0..1 The human readable description of this supplemental data -->
  <criteria value="[string]"/><!-- 0..1 Expression describing additional data to be reported -->
  <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>", // Canonical identifier for this measure, represented as a URI (globally unique)
  "identifier" : [{ Identifier }], // Additional identifier for the measure
  "version" : "<string>", // Business version of the measure
  "name" : "<string>", // Name for this measure (computer friendly)
  "title" : "<string>", // Name for this measure (human friendly)
  "subtitle" : "<string>", // Subordinate title of the measure
  "status" : "<code>", // R!  draft | active | retired | unknown
  "experimental" : <boolean>, // For testing purposes, not real usage
  // subject[x]: E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2:
  "subjectCodeableConcept" : { CodeableConcept },
  "subjectReference" : { Reference(Group) },
  "date" : "<dateTime>", // Date last changed
  "publisher" : "<string>", // Name of the publisher (organization or individual)
  "contact" : [{ ContactDetail }], // Contact details for the publisher
  "description" : "<markdown>", // Natural language description of the measure
  "useContext" : [{ UsageContext }], // The context that the content is intended to support
  "jurisdiction" : [{ CodeableConcept }], // Intended jurisdiction for measure (if applicable)
  "purpose" : "<markdown>", // Why this measure is defined
  "usage" : "<string>", // Describes the clinical usage of the measure
  "copyright" : "<markdown>", // Use and/or publishing restrictions
  "approvalDate" : "<date>", // When the measure was approved by publisher
  "lastReviewDate" : "<date>", // When the measure was last reviewed
  "effectivePeriod" : { Period }, // When the measure is expected to be used
  "topic" : [{ CodeableConcept }], // The category of the measure, such as Education, Treatment, Assessment, etc.
  "contributor" : [{ Contributor }], // A content contributor
  "relatedArtifact" : [{ RelatedArtifact }], // Additional documentation, citations, etc.
  "library" : ["<canonical>"], // Logic used by the measure
  "disclaimer" : "<markdown>", // Disclaimer for use of the measure or its referenced content
  "scoring" : { CodeableConcept }, // proportion | ratio | continuous-variable | cohort
  "compositeScoring" : { CodeableConcept }, // opportunity | all-or-nothing | linear | weighted
  "type" : [{ CodeableConcept }], // process | outcome | structure | patient-reported-outcome | composite
  "riskAdjustment" : "<string>", // How risk adjustment is applied for this measure
  "rateAggregation" : "<string>", // How is rate aggregation performed for this measure
  "rationale" : "<markdown>", // Why does this measure exist
  "clinicalRecommendationStatement" : "<markdown>", // Summary of clinical guidelines
  "improvementNotation" : "<string>", // Improvement notation for the measure, e.g. higher score indicates better quality
  "definition" : ["<markdown>"], // Defined terms used in the measure documentation
  "guidance" : "<markdown>", // Additional guidance for implementers
  "set" : "<string>", // The measure set, e.g. Preventive Care and Screening
  "group" : [{ // Population criteria group
    "code" : { CodeableConcept }, // Meaning of the group
    "description" : "<string>", // Summary description
    "population" : [{ // Population criteria
      "code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      "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
      "code" : { CodeableConcept }, // Meaning of the stratifier
      "description" : "<string>", // The human readable description of this stratifier
      "criteria" : "<string>", // How the measure should be stratified
      "path" : "<string>" // Path to the stratifier
    }]
  }],
  "supplementalData" : [{ // What other data should be reported with the measure
    "code" : { CodeableConcept }, // Meaning of the supplemental data
    "usage" : [{ CodeableConcept }], // supplemental-data | risk-adjustment-factor
    "description" : "<string>", // The human readable description of this supplemental data
    "criteria" : "<string>", // Expression describing additional data to be reported
    "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 Canonical identifier for this measure, represented as a URI (globally unique)
  fhir:Measure.identifier [ Identifier ], ... ; # 0..* Additional identifier for the measure
  fhir:Measure.version [ string ]; # 0..1 Business version of the measure
  fhir:Measure.name [ string ]; # 0..1 Name for this measure (computer friendly)
  fhir:Measure.title [ string ]; # 0..1 Name for this measure (human friendly)
  fhir:Measure.subtitle [ string ]; # 0..1 Subordinate title of the measure
  fhir:Measure.status [ code ]; # 1..1 draft | active | retired | unknown
  fhir:Measure.experimental [ boolean ]; # 0..1 For testing purposes, not real usage
  # Measure.subject[x] : 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2
    fhir:Measure.subjectCodeableConcept [ CodeableConcept ]
    fhir:Measure.subjectReference [ Reference(Group) ]
  fhir:Measure.date [ dateTime ]; # 0..1 Date last changed
  fhir:Measure.publisher [ string ]; # 0..1 Name of the publisher (organization or individual)
  fhir:Measure.contact [ ContactDetail ], ... ; # 0..* Contact details for the publisher
  fhir:Measure.description [ markdown ]; # 0..1 Natural language description of the measure
  fhir:Measure.useContext [ UsageContext ], ... ; # 0..* The context that the content is intended to support
  fhir:Measure.jurisdiction [ CodeableConcept ], ... ; # 0..* Intended jurisdiction for measure (if applicable)
  fhir:Measure.purpose [ markdown ]; # 0..1 Why this measure is defined
  fhir:Measure.usage [ string ]; # 0..1 Describes the clinical usage of the measure
  fhir:Measure.copyright [ markdown ]; # 0..1 Use and/or publishing restrictions
  fhir:Measure.approvalDate [ date ]; # 0..1 When the measure was approved by publisher
  fhir:Measure.lastReviewDate [ date ]; # 0..1 When the measure was last reviewed
  fhir:Measure.effectivePeriod [ Period ]; # 0..1 When the measure is expected to be used
  fhir:Measure.topic [ CodeableConcept ], ... ; # 0..* The category of the measure, such as Education, Treatment, Assessment, etc.
  fhir:Measure.contributor [ Contributor ], ... ; # 0..* A content contributor
  fhir:Measure.relatedArtifact [ RelatedArtifact ], ... ; # 0..* Additional documentation, citations, etc.
  fhir:Measure.library [ canonical(Library) ], ... ; # 0..* Logic used by the measure
  fhir:Measure.disclaimer [ markdown ]; # 0..1 Disclaimer for use of the measure or its referenced content
  fhir:Measure.scoring [ CodeableConcept ]; # 0..1 proportion | ratio | continuous-variable | cohort
  fhir:Measure.compositeScoring [ CodeableConcept ]; # 0..1 opportunity | all-or-nothing | linear | weighted
  fhir:Measure.type [ CodeableConcept ], ... ; # 0..* process | outcome | structure | patient-reported-outcome | composite
  fhir:Measure.riskAdjustment [ string ]; # 0..1 How risk adjustment is 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 Summary of clinical guidelines
  fhir:Measure.improvementNotation [ string ]; # 0..1 Improvement notation for the measure, e.g. higher score indicates better quality
  fhir:Measure.definition [ markdown ], ... ; # 0..* Defined terms used in the measure documentation
  fhir:Measure.guidance [ markdown ]; # 0..1 Additional guidance for implementers
  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.code [ CodeableConcept ]; # 0..1 Meaning of the group
    fhir:Measure.group.description [ string ]; # 0..1 Summary description
    fhir:Measure.group.population [ # 0..* Population criteria
      fhir:Measure.group.population.code [ CodeableConcept ]; # 0..1 initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      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.code [ CodeableConcept ]; # 0..1 Meaning of the stratifier
      fhir:Measure.group.stratifier.description [ string ]; # 0..1 The human readable description of this stratifier
      fhir:Measure.group.stratifier.criteria [ string ]; # 0..1 How the measure should be stratified
      fhir:Measure.group.stratifier.path [ string ]; # 0..1 Path to the stratifier
    ], ...;
  ], ...;
  fhir:Measure.supplementalData [ # 0..* What other data should be reported with the measure
    fhir:Measure.supplementalData.code [ CodeableConcept ]; # 0..1 Meaning of the supplemental data
    fhir:Measure.supplementalData.usage [ CodeableConcept ], ... ; # 0..* supplemental-data | risk-adjustment-factor
    fhir:Measure.supplementalData.description [ string ]; # 0..1 The human readable description of this supplemental data
    fhir:Measure.supplementalData.criteria [ string ]; # 0..1 Expression describing additional data to be reported
    fhir:Measure.supplementalData.path [ string ]; # 0..1 Path to the supplemental data element
  ], ...;
]

Changes since R3

Measure
Measure.subtitle
  • Added Element
Measure.subject[x]
  • Added Element
Measure.library
  • Type changed from Reference(Library) to canonical
Measure.group.code
  • Added Element
Measure.group.stratifier.code
  • Added Element
Measure.group.stratifier.description
  • Added Element
Measure.supplementalData.code
  • Added Element
Measure.supplementalData.description
  • Added Element
Measure.group.identifier
  • deleted
Measure.group.name
  • deleted
Measure.group.population.identifier
  • deleted
Measure.group.population.name
  • deleted
Measure.group.stratifier.identifier
  • deleted
Measure.supplementalData.identifier
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure TUDomainResourceA quality measure definition
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... url Σ0..1uriCanonical identifier for this measure, represented as a URI (globally unique)
... identifier Σ0..*IdentifierAdditional identifier for the measure
... version Σ0..1stringBusiness version of the measure
... name Σ0..1stringName for this measure (computer friendly)
... title Σ0..1stringName for this measure (human friendly)
... subtitle 0..1stringSubordinate title of the measure
... status ?!Σ1..1codedraft | active | retired | unknown
PublicationStatus (Required)
... experimental ?!Σ0..1booleanFor testing purposes, not real usage
... subject[x] 0..1E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
SubjectType (Extensible)
.... subjectCodeableConceptCodeableConcept
.... subjectReferenceReference(Group)
... date Σ0..1dateTimeDate last changed
... publisher Σ0..1stringName of the publisher (organization or individual)
... contact Σ0..*ContactDetailContact details for the publisher
... description Σ0..1markdownNatural language description of the measure
... useContext Σ0..*UsageContextThe context that the content is intended to support
... jurisdiction Σ0..*CodeableConceptIntended jurisdiction for measure (if applicable)
Jurisdiction ValueSet (Extensible)
... purpose 0..1markdownWhy this measure is defined
... usage 0..1stringDescribes the clinical usage of the measure
... copyright 0..1markdownUse and/or publishing restrictions
... approvalDate 0..1dateWhen the measure was approved by publisher
... lastReviewDate 0..1dateWhen the measure was last reviewed
... effectivePeriod Σ0..1PeriodWhen the measure is expected to be used
... topic 0..*CodeableConceptThe category of the measure, such as Education, Treatment, Assessment, etc.
DefinitionTopic (Example)
... contributor 0..*ContributorA content contributor
... relatedArtifact 0..*RelatedArtifactAdditional documentation, citations, etc.
... library 0..*canonicalLogic used by the measure
... disclaimer Σ0..1markdownDisclaimer for use of the measure or its referenced content
... scoring Σ0..1CodeableConceptproportion | ratio | continuous-variable | cohort
MeasureScoring (Extensible)
... compositeScoring Σ0..1CodeableConceptopportunity | all-or-nothing | linear | weighted
CompositeMeasureScoring (Extensible)
... type Σ0..*CodeableConceptprocess | outcome | structure | patient-reported-outcome | composite
MeasureType (Extensible)
... riskAdjustment Σ0..1stringHow risk adjustment is applied for this measure
... rateAggregation Σ0..1stringHow is rate aggregation performed for this measure
... rationale Σ0..1markdownWhy does this measure exist
... clinicalRecommendationStatement Σ0..1markdownSummary of clinical guidelines
... improvementNotation Σ0..1stringImprovement notation for the measure, e.g. higher score indicates better quality
... definition Σ0..*markdownDefined terms used in the measure documentation
... guidance Σ0..1markdownAdditional guidance for implementers
... set Σ0..1stringThe measure set, e.g. Preventive Care and Screening
... group 0..*BackboneElementPopulation criteria group
.... code 0..1CodeableConceptMeaning of the group
.... description 0..1stringSummary description
.... population 0..*BackboneElementPopulation criteria
..... code 0..1CodeableConceptinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
MeasurePopulationType (Extensible)
..... 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
..... code 0..1CodeableConceptMeaning of the stratifier
..... description 0..1stringThe human readable description of this stratifier
..... criteria 0..1stringHow the measure should be stratified
..... path 0..1stringPath to the stratifier
... supplementalData 0..*BackboneElementWhat other data should be reported with the measure
.... code 0..1CodeableConceptMeaning of the supplemental data
.... usage 0..*CodeableConceptsupplemental-data | risk-adjustment-factor
MeasureDataUsage (Extensible)
.... description 0..1stringThe human readable description of this supplemental data
.... criteria 0..1stringExpression describing additional data to be reported
.... path 0..1stringPath to the supplemental data element

doco Documentation for this format

UML Diagram (Legend)

Measure (DomainResource)An absolute URI that is used to identify this measure when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which this measure is (or will be) publishedurl : uri [0..1]A formal identifier that is used to identify this measure when it is represented in other formats, or referenced in a specification, model, design or an instanceidentifier : Identifier [0..*]The identifier that is used to identify this version of the measure when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the measure author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. 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 natural language name identifying the measure. This name should be usable as an identifier for the module by machine processing applications such as code generationname : string [0..1]A short, descriptive, user-friendly title for the measuretitle : string [0..1]An explanatory or alternate title for the measure giving additional information about its contentsubtitle : string [0..1]The status of this measure. Enables tracking the life-cycle of the content (this element modifies the meaning of other elements)status : code [1..1] « The lifecycle status of an artifact. (Strength=Required)PublicationStatus! »A Boolean value to indicate that this measure is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage (this element modifies the meaning of other elements)experimental : boolean [0..1]The intended subjects for the measure. If this element is not provided, a Patient subject is assumed, but the subject of the measure can be anythingsubject[x] : Type [0..1] « CodeableConcept|Reference(Group); The possible types of subjects for a measure (E.g. Patient, Practitioner, Organization, Location, etc.) (Strength=Extensible) SubjectType+ »The date (and optionally time) when the measure was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the measure changesdate : dateTime [0..1]The name of the organization or individual that published the measurepublisher : string [0..1]Contact details to assist a user in finding and communicating with the publishercontact : ContactDetail [0..*]A free text natural language description of the measure from a consumer's perspectivedescription : markdown [0..1]The content was developed with a focus and intent of supporting the contexts that are listed. These terms may be used to assist with indexing and searching for appropriate measure instancesuseContext : UsageContext [0..*]A legal or geographic region in which the measure is intended to be usedjurisdiction : CodeableConcept [0..*] « Countries and regions within which this artifact is targeted for use (Strength=Extensible)Jurisdiction ValueSet+ »Explanation of why this measure is needed and why it has been designed as it haspurpose : markdown [0..1]A detailed description, from a clinical perspective, of how the measure is usedusage : string [0..1]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 : markdown [0..1]The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usageapprovalDate : date [0..1]The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval datelastReviewDate : date [0..1]The period during which the measure content was or is planned to be in active useeffectivePeriod : Period [0..1]Descriptive topics related to the content of the measure. Topics provide a high-level categorization grouping types of measures that can be useful for filtering and searchingtopic : CodeableConcept [0..*] « High-level categorization of the definition, used for searching, sorting, and filtering (Strength=Example)DefinitionTopic?? »A contributor to the content of the measure, including authors, editors, reviewers, and endorserscontributor : Contributor [0..*]Related artifacts such as additional documentation, justification, or bibliographic referencesrelatedArtifact : RelatedArtifact [0..*]A reference to a Library resource containing the formal logic used by the measurelibrary : canonical [0..*]Notices and disclaimers regarding the use of the measure or related to intellectual property (such as code systems) referenced by the measuredisclaimer : markdown [0..1]Indicates how the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort. The value set is extensible, allowing additional measure scoring types to be representedscoring : CodeableConcept [0..1] « The scoring type of the measure (Strength=Extensible)MeasureScoring+ »If this is a composite measure, the scoring method used to combine the component measures to determine the composite scorecompositeScoring : CodeableConcept [0..1] « The composite scoring method of the measure (Strength=Extensible)CompositeMeasureScoring+ »Indicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilizationtype : CodeableConcept [0..*] « The type of measure (includes codes from 2.16.840.1.113883.1.11.20368) (Strength=Extensible)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]Describes how to combine the information calculated, based on logic in each of several populations, into one summarized resultrateAggregation : string [0..1]Provides a succinct statement of the need for the measure. Usually includes statements pertaining to importance criterion: impact, gap in care, and evidencerationale : markdown [0..1]Provides a summary of relevant clinical guidelines or other clinical recommendations supporting the measureclinicalRecommendationStatement : markdown [0..1]Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range)improvementNotation : string [0..1]Provides a description of an individual term used within the measuredefinition : markdown [0..*]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]GroupIndicates a meaning for the group. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing groups to be correlated across measurescode : CodeableConcept [0..1]The human readable description of this population groupdescription : string [0..1]PopulationThe type of population criteriacode : CodeableConcept [0..1] « The type of population (Strength=Extensible)MeasurePopulationType+ »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]StratifierIndicates a meaning for the stratifier. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing stratifiers to be correlated across measurescode : CodeableConcept [0..1]The human readable description of this stratifier criteriadescription : string [0..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]SupplementalDataIndicates a meaning for the supplemental data. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing supplemental data to be correlated across measurescode : CodeableConcept [0..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 : CodeableConcept [0..*] « The intended usage for supplemental data elements in the measure (Strength=Extensible)MeasureDataUsage+ »The human readable description of this supplemental datadescription : string [0..1]The criteria for the supplemental data. This must be the name of a valid expression defined within a referenced library. The criteria 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 Canonical identifier for this measure, represented as a URI (globally unique) -->
 <identifier><!-- 0..* Identifier Additional identifier for the measure --></identifier>
 <version value="[string]"/><!-- 0..1 Business version of the measure -->
 <name value="[string]"/><!-- 0..1 Name for this measure (computer friendly) -->
 <title value="[string]"/><!-- 0..1 Name for this measure (human friendly) -->
 <subtitle value="[string]"/><!-- 0..1 Subordinate title of the measure -->
 <status value="[code]"/><!-- 1..1 draft | active | retired | unknown -->
 <experimental value="[boolean]"/><!-- 0..1 For testing purposes, not real usage -->
 <subject[x]><!-- 0..1 CodeableConcept|Reference(Group) E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device --></subject[x]>
 <date value="[dateTime]"/><!-- 0..1 Date last changed -->
 <publisher value="[string]"/><!-- 0..1 Name of the publisher (organization or individual) -->
 <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact>
 <description value="[markdown]"/><!-- 0..1 Natural language description of the measure -->
 <useContext><!-- 0..* UsageContext The context that the content is intended to support --></useContext>
 <jurisdiction><!-- 0..* CodeableConcept Intended jurisdiction for measure (if applicable) --></jurisdiction>
 <purpose value="[markdown]"/><!-- 0..1 Why this measure is defined -->
 <usage value="[string]"/><!-- 0..1 Describes the clinical usage of the measure -->
 <copyright value="[markdown]"/><!-- 0..1 Use and/or publishing restrictions -->
 <approvalDate value="[date]"/><!-- 0..1 When the measure was approved by publisher -->
 <lastReviewDate value="[date]"/><!-- 0..1 When the measure was last reviewed -->
 <effectivePeriod><!-- 0..1 Period When the measure is expected to be used --></effectivePeriod>
 <topic><!-- 0..* CodeableConcept The category of the measure, such as Education, Treatment, Assessment, etc. --></topic>
 <contributor><!-- 0..* Contributor A content contributor --></contributor>
 <relatedArtifact><!-- 0..* RelatedArtifact Additional documentation, citations, etc. --></relatedArtifact>
 <library><!-- 0..* canonical(Library) Logic used by the measure --></library>
 <disclaimer value="[markdown]"/><!-- 0..1 Disclaimer for use of the measure or its referenced content -->
 <scoring><!-- 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort --></scoring>
 <compositeScoring><!-- 0..1 CodeableConcept opportunity | all-or-nothing | linear | weighted --></compositeScoring>
 <type><!-- 0..* CodeableConcept process | outcome | structure | patient-reported-outcome | composite --></type>
 <riskAdjustment value="[string]"/><!-- 0..1 How risk adjustment is 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 Summary of clinical guidelines -->
 <improvementNotation value="[string]"/><!-- 0..1 Improvement notation for the measure, e.g. higher score indicates better quality -->
 <definition value="[markdown]"/><!-- 0..* Defined terms used in the measure documentation -->
 <guidance value="[markdown]"/><!-- 0..1 Additional guidance for implementers -->
 <set value="[string]"/><!-- 0..1 The measure set, e.g. Preventive Care and Screening -->
 <group>  <!-- 0..* Population criteria group -->
  <code><!-- 0..1 CodeableConcept Meaning of the group --></code>
  <description value="[string]"/><!-- 0..1 Summary description -->
  <population>  <!-- 0..* Population criteria -->
   <code><!-- 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation --></code>
   <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 -->
   <code><!-- 0..1 CodeableConcept Meaning of the stratifier --></code>
   <description value="[string]"/><!-- 0..1 The human readable description of this stratifier -->
   <criteria value="[string]"/><!-- 0..1 How the measure should be stratified -->
   <path value="[string]"/><!-- 0..1 Path to the stratifier -->
  </stratifier>
 </group>
 <supplementalData>  <!-- 0..* What other data should be reported with the measure -->
  <code><!-- 0..1 CodeableConcept Meaning of the supplemental data --></code>
  <usage><!-- 0..* CodeableConcept supplemental-data | risk-adjustment-factor --></usage>
  <description value="[string]"/><!-- 0..1 The human readable description of this supplemental data -->
  <criteria value="[string]"/><!-- 0..1 Expression describing additional data to be reported -->
  <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>", // Canonical identifier for this measure, represented as a URI (globally unique)
  "identifier" : [{ Identifier }], // Additional identifier for the measure
  "version" : "<string>", // Business version of the measure
  "name" : "<string>", // Name for this measure (computer friendly)
  "title" : "<string>", // Name for this measure (human friendly)
  "subtitle" : "<string>", // Subordinate title of the measure
  "status" : "<code>", // R!  draft | active | retired | unknown
  "experimental" : <boolean>, // For testing purposes, not real usage
  // subject[x]: E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2:
  "subjectCodeableConcept" : { CodeableConcept },
  "subjectReference" : { Reference(Group) },
  "date" : "<dateTime>", // Date last changed
  "publisher" : "<string>", // Name of the publisher (organization or individual)
  "contact" : [{ ContactDetail }], // Contact details for the publisher
  "description" : "<markdown>", // Natural language description of the measure
  "useContext" : [{ UsageContext }], // The context that the content is intended to support
  "jurisdiction" : [{ CodeableConcept }], // Intended jurisdiction for measure (if applicable)
  "purpose" : "<markdown>", // Why this measure is defined
  "usage" : "<string>", // Describes the clinical usage of the measure
  "copyright" : "<markdown>", // Use and/or publishing restrictions
  "approvalDate" : "<date>", // When the measure was approved by publisher
  "lastReviewDate" : "<date>", // When the measure was last reviewed
  "effectivePeriod" : { Period }, // When the measure is expected to be used
  "topic" : [{ CodeableConcept }], // The category of the measure, such as Education, Treatment, Assessment, etc.
  "contributor" : [{ Contributor }], // A content contributor
  "relatedArtifact" : [{ RelatedArtifact }], // Additional documentation, citations, etc.
  "library" : ["<canonical>"], // Logic used by the measure
  "disclaimer" : "<markdown>", // Disclaimer for use of the measure or its referenced content
  "scoring" : { CodeableConcept }, // proportion | ratio | continuous-variable | cohort
  "compositeScoring" : { CodeableConcept }, // opportunity | all-or-nothing | linear | weighted
  "type" : [{ CodeableConcept }], // process | outcome | structure | patient-reported-outcome | composite
  "riskAdjustment" : "<string>", // How risk adjustment is applied for this measure
  "rateAggregation" : "<string>", // How is rate aggregation performed for this measure
  "rationale" : "<markdown>", // Why does this measure exist
  "clinicalRecommendationStatement" : "<markdown>", // Summary of clinical guidelines
  "improvementNotation" : "<string>", // Improvement notation for the measure, e.g. higher score indicates better quality
  "definition" : ["<markdown>"], // Defined terms used in the measure documentation
  "guidance" : "<markdown>", // Additional guidance for implementers
  "set" : "<string>", // The measure set, e.g. Preventive Care and Screening
  "group" : [{ // Population criteria group
    "code" : { CodeableConcept }, // Meaning of the group
    "description" : "<string>", // Summary description
    "population" : [{ // Population criteria
      "code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      "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
      "code" : { CodeableConcept }, // Meaning of the stratifier
      "description" : "<string>", // The human readable description of this stratifier
      "criteria" : "<string>", // How the measure should be stratified
      "path" : "<string>" // Path to the stratifier
    }]
  }],
  "supplementalData" : [{ // What other data should be reported with the measure
    "code" : { CodeableConcept }, // Meaning of the supplemental data
    "usage" : [{ CodeableConcept }], // supplemental-data | risk-adjustment-factor
    "description" : "<string>", // The human readable description of this supplemental data
    "criteria" : "<string>", // Expression describing additional data to be reported
    "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 Canonical identifier for this measure, represented as a URI (globally unique)
  fhir:Measure.identifier [ Identifier ], ... ; # 0..* Additional identifier for the measure
  fhir:Measure.version [ string ]; # 0..1 Business version of the measure
  fhir:Measure.name [ string ]; # 0..1 Name for this measure (computer friendly)
  fhir:Measure.title [ string ]; # 0..1 Name for this measure (human friendly)
  fhir:Measure.subtitle [ string ]; # 0..1 Subordinate title of the measure
  fhir:Measure.status [ code ]; # 1..1 draft | active | retired | unknown
  fhir:Measure.experimental [ boolean ]; # 0..1 For testing purposes, not real usage
  # Measure.subject[x] : 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2
    fhir:Measure.subjectCodeableConcept [ CodeableConcept ]
    fhir:Measure.subjectReference [ Reference(Group) ]
  fhir:Measure.date [ dateTime ]; # 0..1 Date last changed
  fhir:Measure.publisher [ string ]; # 0..1 Name of the publisher (organization or individual)
  fhir:Measure.contact [ ContactDetail ], ... ; # 0..* Contact details for the publisher
  fhir:Measure.description [ markdown ]; # 0..1 Natural language description of the measure
  fhir:Measure.useContext [ UsageContext ], ... ; # 0..* The context that the content is intended to support
  fhir:Measure.jurisdiction [ CodeableConcept ], ... ; # 0..* Intended jurisdiction for measure (if applicable)
  fhir:Measure.purpose [ markdown ]; # 0..1 Why this measure is defined
  fhir:Measure.usage [ string ]; # 0..1 Describes the clinical usage of the measure
  fhir:Measure.copyright [ markdown ]; # 0..1 Use and/or publishing restrictions
  fhir:Measure.approvalDate [ date ]; # 0..1 When the measure was approved by publisher
  fhir:Measure.lastReviewDate [ date ]; # 0..1 When the measure was last reviewed
  fhir:Measure.effectivePeriod [ Period ]; # 0..1 When the measure is expected to be used
  fhir:Measure.topic [ CodeableConcept ], ... ; # 0..* The category of the measure, such as Education, Treatment, Assessment, etc.
  fhir:Measure.contributor [ Contributor ], ... ; # 0..* A content contributor
  fhir:Measure.relatedArtifact [ RelatedArtifact ], ... ; # 0..* Additional documentation, citations, etc.
  fhir:Measure.library [ canonical(Library) ], ... ; # 0..* Logic used by the measure
  fhir:Measure.disclaimer [ markdown ]; # 0..1 Disclaimer for use of the measure or its referenced content
  fhir:Measure.scoring [ CodeableConcept ]; # 0..1 proportion | ratio | continuous-variable | cohort
  fhir:Measure.compositeScoring [ CodeableConcept ]; # 0..1 opportunity | all-or-nothing | linear | weighted
  fhir:Measure.type [ CodeableConcept ], ... ; # 0..* process | outcome | structure | patient-reported-outcome | composite
  fhir:Measure.riskAdjustment [ string ]; # 0..1 How risk adjustment is 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 Summary of clinical guidelines
  fhir:Measure.improvementNotation [ string ]; # 0..1 Improvement notation for the measure, e.g. higher score indicates better quality
  fhir:Measure.definition [ markdown ], ... ; # 0..* Defined terms used in the measure documentation
  fhir:Measure.guidance [ markdown ]; # 0..1 Additional guidance for implementers
  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.code [ CodeableConcept ]; # 0..1 Meaning of the group
    fhir:Measure.group.description [ string ]; # 0..1 Summary description
    fhir:Measure.group.population [ # 0..* Population criteria
      fhir:Measure.group.population.code [ CodeableConcept ]; # 0..1 initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      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.code [ CodeableConcept ]; # 0..1 Meaning of the stratifier
      fhir:Measure.group.stratifier.description [ string ]; # 0..1 The human readable description of this stratifier
      fhir:Measure.group.stratifier.criteria [ string ]; # 0..1 How the measure should be stratified
      fhir:Measure.group.stratifier.path [ string ]; # 0..1 Path to the stratifier
    ], ...;
  ], ...;
  fhir:Measure.supplementalData [ # 0..* What other data should be reported with the measure
    fhir:Measure.supplementalData.code [ CodeableConcept ]; # 0..1 Meaning of the supplemental data
    fhir:Measure.supplementalData.usage [ CodeableConcept ], ... ; # 0..* supplemental-data | risk-adjustment-factor
    fhir:Measure.supplementalData.description [ string ]; # 0..1 The human readable description of this supplemental data
    fhir:Measure.supplementalData.criteria [ string ]; # 0..1 Expression describing additional data to be reported
    fhir:Measure.supplementalData.path [ string ]; # 0..1 Path to the supplemental data element
  ], ...;
]

Changes since DSTU2

Measure
Measure.subtitle
  • Added Element
Measure.subject[x]
  • Added Element
Measure.library
  • Type changed from Reference(Library) to canonical
Measure.group.code
  • Added Element
Measure.group.stratifier.code
  • Added Element
Measure.group.stratifier.description
  • Added Element
Measure.supplementalData.code
  • Added Element
Measure.supplementalData.description
  • Added Element
Measure.group.identifier
  • deleted
Measure.group.name
  • deleted
Measure.group.population.identifier
  • deleted
Measure.group.population.name
  • deleted
Measure.group.stratifier.identifier
  • deleted
Measure.supplementalData.identifier
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

 

Alternate definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions & the dependency analysis

14.11.3.1 Terminology Bindings

PathDefinitionTypeReference
Measure.status The lifecycle status of an artifact.RequiredPublicationStatus
Measure.subject[x] The possible types of subjects for a measure (E.g. Patient, Practitioner, Organization, Location, etc.)ExtensibleSubjectType
Measure.jurisdiction Countries and regions within which this artifact is targeted for useExtensibleJurisdiction ValueSet
Measure.topic High-level categorization of the definition, used for searching, sorting, and filteringExampleDefinitionTopic
Measure.scoring The scoring type of the measureExtensibleMeasureScoring
Measure.compositeScoring The composite scoring method of the measureExtensibleCompositeMeasureScoring
Measure.type The type of measure (includes codes from 2.16.840.1.113883.1.11.20368)ExtensibleMeasureType
Measure.group.population.code The type of populationExtensibleMeasurePopulationType
Measure.supplementalData.usage The intended usage for supplemental data elements in the measureExtensibleMeasureDataUsage

14.11.4 Search Parameters

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

NameTypeDescriptionExpressionIn Common
composed-ofreferenceWhat resource is being referencedMeasure.relatedArtifact.where(type='composed-of').resource
datedateThe measure publication dateMeasure.date
depends-onreferenceWhat resource is being referencedMeasure.relatedArtifact.where(type='depends-on').resource | Measure.library
(Library)
derived-fromreferenceWhat resource is being referencedMeasure.relatedArtifact.where(type='derived-from').resource
descriptionstringThe description of the measureMeasure.description
effectivedateThe time during which the measure is intended to be in useMeasure.effectivePeriod
identifiertokenExternal identifier for the measureMeasure.identifier
jurisdictiontokenIntended jurisdiction for the measureMeasure.jurisdiction
namestringComputationally friendly name of the measureMeasure.name
predecessorreferenceWhat resource is being referencedMeasure.relatedArtifact.where(type='predecessor').resource
publisherstringName of the publisher of the measureMeasure.publisher
statustokenThe current status of the measureMeasure.status
successorreferenceWhat resource is being referencedMeasure.relatedArtifact.where(type='successor').resource
titlestringThe human-friendly name of the measureMeasure.title
topictokenTopics associated with the measureMeasure.topic
urluriThe uri that identifies the measureMeasure.url
versiontokenThe business version of the measureMeasure.version