Release 5 Preview #2
Clinical ReasoningThis page is part of the FHIR Specification (v4.4.0: R5 Preview #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 R2
| Clinical Quality Information Work Group | Maturity Level: 2 | Trial Use | Security Category: Business | Compartments: Patient |
The MeasureReport resource contains the results of the calculation of a measure; and optionally a reference to the resources involved in that calculation.
The MeasureReport resource represents the results of calculating a measure for a specific subject or group of subjects. The $evaluate-measure operation of the Measure resource is defined to return a MeasureReport. The resource is capable of representing three different levels of report: individual, subject-list, and summary.
The resource draws requirements from the HL7 CDA R2 Implementation Guide: Quality Reporting Document Architecture - Category 1 (QRDA I) DSTU Release 3 (US Realm) and the HL7 Implementation Guide for CDA Release 2: Quality Reporting Document Architecture - Category III (QRDA III), DSTU Release 1 implementation guides.
For a detailed discussion of how to use the Measure and MeasureReport resources, refer to the Quality Reporting topic.
Note that this resource is a special case of the more general notion of a query evaluation result. However, because the general case requires the ability to represent arbitrary content, this resource uses a simple indicator structure to describe population sizes for each population type defined in the measure. The intent is to be able to represent the more general case as well, either by generalizing this resource, or by making this structure a profile of a more general resource, and we are actively seeking comments about what approaches might be taken to achieve that aim.
Although the MeasureReport is conceptually an Observation, there is enough specific information required to support the quality reporting use case to warrant a separate resource.
The resource is differentiated from a general purpose query result because it communicates specific information related to quality measurement evaluation that would be difficult to convey generally without imposing some other structure on top of the general results.
No resources refer to this resource directly.
This resource does not implement any patterns.
Structure
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  MeasureReport | TU | DomainResource | Results of a measure evaluation + Rule: Measure Reports used for data collection SHALL NOT communicate group and score information + Rule: Stratifiers SHALL be either a single criteria or a set of criteria components Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension | |
  identifier | Σ | 0..* | Identifier | Additional identifier for the MeasureReport |
 status | ?!Σ | 1..1 | code | complete | pending | error MeasureReportStatus (Required) |
| type | ΣI | 1..1 | code | individual | subject-list | summary | data-collection MeasureReportType (Required) |
 measure | Σ | 1..1 | canonical(Measure) | What measure was calculated |
| subject | Σ | 0..1 | Reference(Patient | Practitioner | PractitionerRole | Location | Device | RelatedPerson | Group) | What individual(s) the report is for |
| date | Σ | 0..1 | dateTime | When the report was generated |
| reporter | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Location | Organization) | Who is reporting the data |
| period | Σ | 1..1 | Period | What period the report covers |
| improvementNotation | ?!Σ | 0..1 | CodeableConcept | increase | decrease MeasureImprovementNotation (Required) |
  group | I | 0..* | BackboneElement | Measure results for each group |
 code | Σ | 0..1 | CodeableConcept | Meaning of the group |
| population | 0..* | BackboneElement | The populations in the group | |
| code | Σ | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation MeasurePopulationType (Extensible) |
| count | 0..1 | integer | Size of the population | |
 subjectResults | 0..1 | Reference(List) | For subject-list reports, the subject results in this population | |
| measureScore | Σ | 0..1 | Quantity | What score this group achieved |
 stratifier | 0..* | BackboneElement | Stratification results | |
 code | 0..* | CodeableConcept | What stratifier of the group | |
| stratum | 0..* | BackboneElement | Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components | |
| value | 0..1 | CodeableConcept | The stratum value, e.g. male | |
| component | 0..* | BackboneElement | Stratifier component values | |
| code | 1..1 | CodeableConcept | What stratifier component of the group | |
| value | 1..1 | CodeableConcept | The stratum component value, e.g. male | |
| population | 0..* | BackboneElement | Population results in this stratum | |
| code | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation MeasurePopulationType (Extensible) | |
| count | 0..1 | integer | Size of the population | |
| subjectResults | 0..1 | Reference(List) | For subject-list reports, the subject results in this population | |
| measureScore | 0..1 | Quantity | What score this stratum achieved | |
| evaluatedResource | 0..* | Reference(Any) | What data was used to calculate the measure score | |
| Documentation for this format | ||||
UML Diagram (Legend)
XML Template
<MeasureReport xmlns="http://hl7.org/fhir"><!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <identifier><!-- 0..* Identifier Additional identifier for the MeasureReport --></identifier> <status value="[code]"/><!-- 1..1 complete | pending | error --> <type value="[code]"/><!--
1..1 individual | subject-list | summary | data-collection --> <measure><!-- 1..1 canonical(Measure) What measure was calculated --></measure> <subject><!-- 0..1 Reference(Device|Group|Location|Patient|Practitioner| PractitionerRole|RelatedPerson) What individual(s) the report is for --></subject> <date value="[dateTime]"/><!-- 0..1 When the report was generated --> <reporter><!-- 0..1 Reference(Location|Organization|Practitioner| PractitionerRole) Who is reporting the data --></reporter> <period><!-- 1..1 Period What period the report covers --></period> <improvementNotation><!-- 0..1 CodeableConcept increase | decrease --></improvementNotation> <group> <!--
JSON Template
{
"resourceType" : "MeasureReport",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"identifier" : [{ Identifier }], // Additional identifier for the MeasureReport
"status" : "<code>", // R! complete | pending | error
"type" : "<code>", // C? R! individual | subject-list | summary | data-collection
"measure" : { canonical(Measure) }, // R! What measure was calculated
"subject" : { Reference(Device|Group|Location|Patient|Practitioner|
PractitionerRole|RelatedPerson) }, // What individual(s) the report is for
"date" : "<dateTime>", // When the report was generated
"reporter" : { Reference(Location|Organization|Practitioner|
PractitionerRole) }, // Who is reporting the data
"period" : { Period }, // R! What period the report covers
"improvementNotation" : { CodeableConcept }, // increase | decrease
"group" : [{ // C? Measure results for each group
"code" : { CodeableConcept }, // Meaning of the group
"population" : [{ // The populations in the group
"code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
"count" : <integer>, // Size of the population
"subjectResults" : { Reference(List) } // For subject-list reports, the subject results in this population
}],
"measureScore" : { Quantity }, // What score this group achieved
"stratifier" : [{ // Stratification results
"code" : [{ CodeableConcept }], // What stratifier of the group
"stratum" : [{ // Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
"value" : { CodeableConcept }, // The stratum value, e.g. male
"component" : [{ // Stratifier component values
"code" : { CodeableConcept }, // R! What stratifier component of the group
"value" : { CodeableConcept } // R! The stratum component value, e.g. male
}],
"population" : [{ // Population results in this stratum
"code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
"count" : <integer>, // Size of the population
"subjectResults" : { Reference(List) } // For subject-list reports, the subject results in this population
}],
"measureScore" : { Quantity } // What score this stratum achieved
}]
}]
}],
"evaluatedResource" : [{ Reference(Any) }] // What data was used to calculate the measure score
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .
Changes since R3
| MeasureReport | |
| MeasureReport.status |
|
| MeasureReport.type |
|
| MeasureReport.improvementNotation |
|
See the Full Difference for further information
This analysis is available as XML or JSON.
See R3 <--> R4 Conversion Maps (status = 3 tests that all execute ok. All tests pass round-trip testing and 3 r3 resources are invalid (0 errors).)
Structure
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| MeasureReport | TU | DomainResource | Results of a measure evaluation + Rule: Measure Reports used for data collection SHALL NOT communicate group and score information + Rule: Stratifiers SHALL be either a single criteria or a set of criteria components Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension | |
| identifier | Σ | 0..* | Identifier | Additional identifier for the MeasureReport |
| status | ?!Σ | 1..1 | code | complete | pending | error MeasureReportStatus (Required) |
| type | ΣI | 1..1 | code | individual | subject-list | summary | data-collection MeasureReportType (Required) |
| measure | Σ | 1..1 | canonical(Measure) | What measure was calculated |
| subject | Σ | 0..1 | Reference(Patient | Practitioner | PractitionerRole | Location | Device | RelatedPerson | Group) | What individual(s) the report is for |
| date | Σ | 0..1 | dateTime | When the report was generated |
| reporter | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Location | Organization) | Who is reporting the data |
| period | Σ | 1..1 | Period | What period the report covers |
| improvementNotation | ?!Σ | 0..1 | CodeableConcept | increase | decrease MeasureImprovementNotation (Required) |
| group | I | 0..* | BackboneElement | Measure results for each group |
| code | Σ | 0..1 | CodeableConcept | Meaning of the group |
| population | 0..* | BackboneElement | The populations in the group | |
| code | Σ | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation MeasurePopulationType (Extensible) |
| count | 0..1 | integer | Size of the population | |
| subjectResults | 0..1 | Reference(List) | For subject-list reports, the subject results in this population | |
| measureScore | Σ | 0..1 | Quantity | What score this group achieved |
| stratifier | 0..* | BackboneElement | Stratification results | |
| code | 0..* | CodeableConcept | What stratifier of the group | |
| stratum | 0..* | BackboneElement | Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components | |
| value | 0..1 | CodeableConcept | The stratum value, e.g. male | |
| component | 0..* | BackboneElement | Stratifier component values | |
| code | 1..1 | CodeableConcept | What stratifier component of the group | |
| value | 1..1 | CodeableConcept | The stratum component value, e.g. male | |
| population | 0..* | BackboneElement | Population results in this stratum | |
| code | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation MeasurePopulationType (Extensible) | |
| count | 0..1 | integer | Size of the population | |
| subjectResults | 0..1 | Reference(List) | For subject-list reports, the subject results in this population | |
| measureScore | 0..1 | Quantity | What score this stratum achieved | |
| evaluatedResource | 0..* | Reference(Any) | What data was used to calculate the measure score | |
| Documentation for this format | ||||
XML Template
<MeasureReport xmlns="http://hl7.org/fhir">
JSON Template
{
"resourceType" : "MeasureReport",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"identifier" : [{ Identifier }], // Additional identifier for the MeasureReport
"status" : "<code>", // R! complete | pending | error
"type" : "<code>", // C? R! individual | subject-list | summary | data-collection
"measure" : { canonical(Measure) }, // R! What measure was calculated
"subject" : { Reference(Device|Group|Location|Patient|Practitioner|
PractitionerRole|RelatedPerson) }, // What individual(s) the report is for
"date" : "<dateTime>", // When the report was generated
"reporter" : { Reference(Location|Organization|Practitioner|
PractitionerRole) }, // Who is reporting the data
"period" : { Period }, // R! What period the report covers
"improvementNotation" : { CodeableConcept }, // increase | decrease
"group" : [{ // C? Measure results for each group
"code" : { CodeableConcept }, // Meaning of the group
"population" : [{ // The populations in the group
"code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
"count" : <integer>, // Size of the population
"subjectResults" : { Reference(List) } // For subject-list reports, the subject results in this population
}],
"measureScore" : { Quantity }, // What score this group achieved
"stratifier" : [{ // Stratification results
"code" : [{ CodeableConcept }], // What stratifier of the group
"stratum" : [{ // Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
"value" : { CodeableConcept }, // The stratum value, e.g. male
"component" : [{ // Stratifier component values
"code" : { CodeableConcept }, // R! What stratifier component of the group
"value" : { CodeableConcept } // R! The stratum component value, e.g. male
}],
"population" : [{ // Population results in this stratum
"code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
"count" : <integer>, // Size of the population
"subjectResults" : { Reference(List) } // For subject-list reports, the subject results in this population
}],
"measureScore" : { Quantity } // What score this stratum achieved
}]
}]
}],
"evaluatedResource" : [{ Reference(Any) }] // What data was used to calculate the measure score
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .
Changes since Release 3
| MeasureReport | |
| MeasureReport.status |
|
| MeasureReport.type |
|
| MeasureReport.improvementNotation |
|
See the Full Difference for further information
This analysis is available as XML or JSON.
See R3 <--> R4 Conversion Maps (status = 3 tests that all execute ok. All tests pass round-trip testing and 3 r3 resources are invalid (0 errors).)
See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis a
| Path | Definition | Type | Reference |
|---|---|---|---|
| MeasureReport.status | The status of the measure report. | Required | MeasureReportStatus |
| MeasureReport.type | The type of the measure report. | Required | MeasureReportType |
| MeasureReport.improvementNotation | Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue. | Required | MeasureImprovementNotation |
| MeasureReport.group.population.code MeasureReport.group.stratifier.stratum.population.code | The type of population (e.g. initial, numerator, denominator, etc.). | Extensible | MeasurePopulationType |
| id | Level | Location | Description | Expression |
| mrp-1 | Rule | (base) | Measure Reports used for data collection SHALL NOT communicate group and score information | (type != 'data-collection') or group.exists().not() |
| mrp-2 | Rule | (base) | Stratifiers SHALL be either a single criteria or a set of criteria components | group.stratifier.stratum.all(value.exists() xor component.exists()) |
Although the MeasureReport resource does define search parameters, it is up to the individual measure evaluation service whether or not historical records of measure evaluation requests are preserved. A service might not support searching on MeasureReports at all, or it may support searching only for a pre-defined expiration period. The search parameters are defined to provide consumers with a consistent interface to searching if it is available for a specific service implementation. In any case, services should detail the support they do provide using a CapabilityStatement.
Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.
| Name | Type | Description | Expression | In Common |
| date N | date | The date of the measure report | MeasureReport.date | |
| evaluated-resource | reference | An evaluated resource referenced by the measure report | MeasureReport.evaluatedResource (Any) | |
| identifier | token | External identifier of the measure report to be returned | MeasureReport.identifier | |
| measure N | reference | The measure to return measure report results for | MeasureReport.measure (Measure) | |
| patient | reference | The identity of a patient to search for individual measure report results for | MeasureReport.subject.where(resolve() is Patient) (Patient) | |
| period | date | The period of the measure report | MeasureReport.period | |
| reporter | reference | The reporter to return measure report results for | MeasureReport.reporter (Practitioner, Organization, PractitionerRole, Location) | |
| status N | token | The status of the measure report | MeasureReport.status | |
| subject | reference | The identity of a subject to search for individual measure report results for | MeasureReport.subject (Practitioner, Group, Device, Patient, PractitionerRole, RelatedPerson, Location) |
FHIR ®© HL7.org 2011+. FHIR CI Build hl7.fhir.core#4.4.0 generated on Sun, May 3, 2020 08:47+1000.
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