StructureDefinition: PublishableMeasure - XML

PublishableMeasure

<?xml version="1.0" encoding="UTF-8"?>

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="publishablemeasure"/> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">to do</div> 
  </text> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="3"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="cds"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use"/> 
  </extension> 
  <url value="http://hl7.org/fhir/StructureDefinition/publishablemeasure"/> 
  <version value="5.0.0"/> 
  <name value="PublishableMeasure"/> 
  <title value="Publishable Measure"/> 
  <status value="draft"/> 
  <experimental value="false"/> 
  <date value="2020-12-28T16:55:11+11:00"/> 
  <publisher value="HL7"/> 
  <description value="Supports declaration of the Measure metadata required by HL7 and other organizations
   that share and publish measures with a focus on the aspects of that metadata that
   are important for post-publication activities including distribution, inclusion
   in repositories, consumption, and implementation."/> 
  <fhirVersion value="5.0.0"/> 
  <mapping> 
    <identity value="rim"/> 
    <uri value="http://hl7.org/v3"/> 
    <name value="RIM Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="workflow"/> 
    <uri value="http://hl7.org/fhir/workflow"/> 
    <name value="Workflow Pattern"/> 
  </mapping> 
  <mapping> 
    <identity value="w5"/> 
    <uri value="http://hl7.org/fhir/fivews"/> 
    <name value="FiveWs Pattern Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="objimpl"/> 
    <uri value="http://hl7.org/fhir/object-implementation"/> 
    <name value="Object Implementation Information"/> 
  </mapping> 
  <kind value="resource"/> 
  <abstract value="false"/> 
  <type value="Measure"/> 
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/shareablemeasure"/> 
  <derivation value="constraint"/> 
  <snapshot> 
    <element id="Measure">
      <path value="Measure"/> 
      <short value="A quality measure definition"/> 
      <definition value="The Measure resource provides the definition of a quality measure."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <constraint> 
        <key value="cnl-0"/> 
        <severity value="warning"/> 
        <human value="Name should be usable as an identifier for the module by machine processing applications
         such as code generation"/> 
        <expression value="name.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$')"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Measure"/> 
      </constraint> 
      <constraint> 
        <key value="mea-1"/> 
        <severity value="error"/> 
        <human value="Stratifier SHALL be either a single criteria or a set of criteria components"/> 
        <expression value="group.stratifier.all((code | description | criteria).exists() xor component.exists())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Measure"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="conformance.behavior,clinical.general"/> 
      </mapping> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Observation[classCode=OBS, moodCode=DEFN]"/> 
      </mapping> 
    </element> 
    <element id="Measure.id">
      <path value="Measure.id"/> 
      <short value="Logical id of this artifact"/> 
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned,
       this value never changes."/> 
      <comment value="Within the context of the FHIR RESTful interactions, the resource has an id except
       for cases like the create and conditional update. Otherwise, the use of the resouce
       id depends on the given use case."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Measure.meta">
      <path value="Measure.meta"/> 
      <short value="Metadata about the resource"/> 
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
       Changes to the content might not always be associated with version changes to the
       resource."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.meta"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Meta"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Measure.implicitRules">
      <path value="Measure.implicitRules"/> 
      <short value="A set of rules under which this content was created"/> 
      <definition value="A reference to a set of rules that were followed when the resource was constructed,
       and which must be understood when processing the content. Often, this is a reference
       to an implementation guide that defines the special rules along with other profiles
       etc."/> 
      <comment value="Asserting this rule set restricts the content to be only understood by a limited
       set of trading partners. This inherently limits the usefulness of the data in the
       long term. However, the existing health eco-system is highly fractured, and not
       yet ready to define, collect, and exchange data in a generally computable sense.
       Wherever possible, implementers and/or specification writers should avoid using
       this element. Often, when used, the URL is a reference to an implementation guide
       that defines these special rules as part of its narrative along with other profiles,
       value sets, etc."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.implicitRules"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional
       knowledge about the resource that modifies its meaning or interpretation"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Measure.language">
      <path value="Measure.language"/> 
      <short value="Language of the resource content"/> 
      <definition value="The base language in which the resource is written."/> 
      <comment value="Language is provided to support indexing and accessibility (typically, services
       such as text to speech use the language tag). The html language tag in the narrative
       applies  to the narrative. The language tag on the resource may be used to specify
       the language of other presentations generated from the data in the resource. Not
       all the content has to be in the base language. The Resource.language should not
       be assumed to apply to the narrative automatically. If a language is specified,
       it should it also be specified on the div element in the html (see rules in HTML5
       for information about the relationship between xml:lang and the html lang attribute)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.language"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="required"/> 
        <description value="IETF language tag for a human language"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|5.0.0"/> 
        <additional> 
          <purpose value="starter"/> 
          <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> 
        </additional> 
      </binding> 
    </element> 
    <element id="Measure.text">
      <path value="Measure.text"/> 
      <short value="Text summary of the resource, for human interpretation"/> 
      <definition value="A human-readable narrative that contains a summary of the resource and can be used
       to represent the content of the resource to a human. The narrative need not encode
       all the structured data, but is required to contain sufficient detail to make it
       &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions
       may define what content should be represented in the narrative to ensure clinical
       safety."/> 
      <comment value="Contained resources do not have a narrative. Resources that are not contained SHOULD
       have a narrative. In some cases, a resource may only have text with little or no
       additional discrete data (as long as all minOccurs=1 elements are satisfied). 
       This may be necessary for data from legacy systems where information is captured
       as a &quot;text blob&quot; or where text is additionally entered raw or narrated
       and encoded information is added later."/> 
      <alias value="narrative"/> 
      <alias value="html"/> 
      <alias value="xhtml"/> 
      <alias value="display"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DomainResource.text"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Narrative"/> 
      </type> 
      <condition value="dom-6"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Act.text?"/> 
      </mapping> 
    </element> 
    <element id="Measure.contained">
      <path value="Measure.contained"/> 
      <short value="Contained, inline Resources"/> 
      <definition value="These resources do not have an independent existence apart from the resource that
       contains them - they cannot be identified independently, nor can they have their
       own independent transaction scope. This is allowed to be a Parameters resource
       if and only if it is referenced by a resource that provides context/meaning."/> 
      <comment value="This should never be done when the content can be identified properly, as once
       identification is lost, it is extremely difficult (and context dependent) to restore
       it again. Contained resources may have profiles and tags in their meta elements,
       but SHALL NOT have security labels."/> 
      <alias value="inline resources"/> 
      <alias value="anonymous resources"/> 
      <alias value="contained resources"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.contained"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Resource"/> 
      </type> 
      <condition value="dom-2"/> 
      <condition value="dom-4"/> 
      <condition value="dom-3"/> 
      <condition value="dom-5"/> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Measure.extension">
      <path value="Measure.extension"/> 
      <slicing> 
        <discriminator> 
          <type value="value"/> 
          <path value="url"/> 
        </discriminator> 
        <ordered value="false"/> 
        <rules value="open"/> 
      </slicing> 
      <short value="Extension"/> 
      <definition value="An Extension"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="Measure.extension:knowledgeCapability">
      <path value="Measure.extension"/> 
      <sliceName value="knowledgeCapability"/> 
      <short value="shareable | computable | publishable | executable"/> 
      <definition value="Defines a knowledge capability afforded by this knowledge artifact."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
    </element> 
    <element id="Measure.extension:knowledgeRepresentationLevel">
      <path value="Measure.extension"/> 
      <sliceName value="knowledgeRepresentationLevel"/> 
      <short value="narrative | semi-structured | structured | executable"/> 
      <definition value="Defines a knowledge representation level provided by this knowledge artifact."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeRepresentationLevel"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
    </element> 
    <element id="Measure.extension:artifactComment">
      <path value="Measure.extension"/> 
      <sliceName value="artifactComment"/> 
      <short value="Additional documentation, review, or usage guidance"/> 
      <definition value="A comment containing additional documentation, a review comment, usage guidance,
       or other relevant information from a particular user."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/cqf-artifactComment"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
    </element> 
    <element id="Measure.modifierExtension">
      <path value="Measure.modifierExtension"/> 
      <short value="Extensions that cannot be ignored"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource and that modifies the understanding of the element that contains
       it and/or the understanding of the containing element's descendants. Usually modifier
       elements provide negation or qualification. To make the use of extensions safe
       and managable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there
       is a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       resource that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Measure.url">
      <path value="Measure.url"/> 
      <short value="Canonical identifier for this measure, represented as a URI (globally unique)"/> 
      <definition value="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 an authoritative
       instance of this measure is (or will be) published. This URL can be the target
       of a canonical reference. It SHALL remain the same when the measure is stored on
       different servers."/> 
      <comment value="Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred.  Multiple
       instances may share the same URL if they have a distinct version.

The determination of when to create a new version of a resource (same url, new
       version) vs. defining a new artifact is up to the author.  Considerations for making
       this decision are found in [Technical and Business Versions](resource.html#versions).
       

In some cases, the resource can no longer be found at the stated url, but the url
       itself cannot change. Implementations can use the [meta.source](resource.html#meta)
       element to indicate where the current master source of the resource can be found."/> 
      <requirements value="Allows the measure to be referenced by a single globally unique identifier."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.url"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="cnl-1"/> 
        <severity value="warning"/> 
        <human value="URL should not contain | or # - these characters make processing canonical references
         problematic"/> 
        <expression value="exists() implies matches('^[^|# ]+$')"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Measure"/> 
      </constraint> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.url"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".identifier[scope=BUSN;reliability=ISS]"/> 
      </mapping> 
    </element> 
    <element id="Measure.identifier">
      <path value="Measure.identifier"/> 
      <short value="Additional identifier for the measure"/> 
      <definition value="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 instance."/> 
      <comment value="Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier)
       data type, and can then identify this measure outside of FHIR, where it is not
       possible to use the logical URI."/> 
      <requirements value="Allows externally provided and/or usable business identifiers to be easily associated
       with the module."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.identifier"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Measure.version">
      <path value="Measure.version"/> 
      <short value="Business version of the measure"/> 
      <definition value="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 artifacts."/> 
      <comment value="There may be different measure instances that have the same identifier but different
       versions.  The version can be appended to the url in a reference to allow a reference
       to a particular business version of the measure with the format [url]|[version].
       The version SHOULD NOT contain a '#' - see [Business Version](resource.html#bv-format)."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.version"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.version"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.version"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Measure.versionAlgorithm[x]">
      <path value="Measure.versionAlgorithm[x]"/> 
      <short value="How to compare versions"/> 
      <definition value="Indicates the mechanism used to compare versions to determine which is more current."/> 
      <comment value="If set as a string, this is a FHIRPath expression that has two additional context
       variables passed in - %version1 and %version2 and will return a negative number
       if version1 is newer, a positive number if version2 and a 0 if the version ordering
       can't be successfully be determined."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.versionAlgorithm[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <type> 
        <code value="Coding"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <strength value="extensible"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/version-algorithm"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.versionAlgorithm"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.version"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Measure.name">
      <path value="Measure.name"/> 
      <short value="Name for this measure (computer friendly)"/> 
      <definition value="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 generation."/> 
      <comment value="The name is not expected to be globally unique. The name should be a simple alphanumeric
       type name to ensure that it is machine-processing friendly."/> 
      <requirements value="Support human navigation and code generation."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.name"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <condition value="cnl-0"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.name"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Measure.title">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <path value="Measure.title"/> 
      <short value="Name for this measure (human friendly)"/> 
      <definition value="A short, descriptive, user-friendly title for the measure."/> 
      <comment value="This name does not need to be machine-processing friendly and may contain punctuation,
       white-space, etc."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.title"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.title"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".title"/> 
      </mapping> 
    </element> 
    <element id="Measure.subtitle">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <path value="Measure.subtitle"/> 
      <short value="Subordinate title of the measure"/> 
      <definition value="An explanatory or alternate title for the measure giving additional information
       about its content."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.subtitle"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.status">
      <path value="Measure.status"/> 
      <short value="draft | active | retired | unknown"/> 
      <definition value="The status of this measure. Enables tracking the life-cycle of the content."/> 
      <comment value="Allows filtering of measures that are appropriate for use versus not.

See guidance around (not) making local changes to elements [here](canonicalresource.html#loca
      lization)."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.status"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because applications should not use
       a retired {{title}} without due consideration"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="PublicationStatus"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="required"/> 
        <description value="The lifecycle status of an artifact."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/publication-status|5.0.0"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.status"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.status"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".status"/> 
      </mapping> 
    </element> 
    <element id="Measure.experimental">
      <path value="Measure.experimental"/> 
      <short value="For testing purposes, not real usage"/> 
      <definition value="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."/> 
      <comment value="Allows filtering of measures that are appropriate for use versus not."/> 
      <requirements value="Enables experimental content to be developed following the same lifecycle that
       would be used for a production-level measure."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.experimental"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <meaningWhenMissing value="If absent, this resource is treated as though it is not experimental."/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.experimental"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.subject[x]">
      <path value="Measure.subject[x]"/> 
      <short value="E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device"/> 
      <definition value="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 anything."/> 
      <comment value="The subject of the measure is critical in interpreting the criteria definitions,
       as the logic in the measures is evaluated with respect to a particular subject.
       This corresponds roughly to the notion of a Compartment in that it limits what
       content is available based on its relationship to the subject. In CQL, this corresponds
       to the context declaration."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.subject[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> 
      </type> 
      <meaningWhenMissing value="Patient"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="SubjectType"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="The possible types of subjects for a measure (E.g. Patient, Practitioner, Organization,
         Location, etc.)."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/participant-resource-types"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?) { only applies for subject Patient? }"/> 
      </mapping> 
    </element> 
    <element id="Measure.basis">
      <path value="Measure.basis"/> 
      <short value="Population basis"/> 
      <definition value="The population basis specifies the type of elements in the population. For a subject-based
       measure, this is boolean (because the subject and the population basis are the
       same, and the population criteria define yes/no values for each individual in the
       population). For measures that have a population basis that is different than the
       subject, this element specifies the type of the population basis. For example,
       an encounter-based measure has a subject of Patient and a population basis of Encounter,
       and the population criteria all return lists of Encounters."/> 
      <comment value="For a subject-based measure, the population basis is simply boolean; all the criteria
       are expressed as true/false conditions that determine membership of an individual
       case in the population. For non-subject-based measures, the population basis can
       be any resource type, and the criteria are queries that return the subject's contribution
       to the population as a list of that resource type. For example, for a procedure-based
       measure, the population criteria would return lists of procedures that should be
       included in each population."/> 
      <requirements value="Allows non-subject-based measures to be specified. Note that because the binding
       is to all fhir types, it is possible to specify abstract types such as Resource
       or DomainResource as the basis for a measure. Authoring environments may wish to
       constrain this further, depending on content needs."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.basis"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <meaningWhenMissing value="boolean"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="BasisType"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="required"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/fhir-types|5.0.0"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?) { only applies for subject Patient? }"/> 
      </mapping> 
    </element> 
    <element id="Measure.date">
      <path value="Measure.date"/> 
      <short value="Date last changed"/> 
      <definition value="The date  (and optionally time) when the measure was last significantly changed.
       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 changes."/> 
      <comment value="The date is often not tracked until the resource is published, but may be present
       on draft content. Note that this is not the same as the resource last-modified-date,
       since the resource may be a secondary representation of the measure. Additional
       specific dates may be added as extensions or be found by consulting Provenances
       associated with past versions of the resource.

See guidance around (not) making local changes to elements [here](canonicalresource.html#loca
      lization)."/> 
      <alias value="Revision Date"/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.date"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.date"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.recorded"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].time"/> 
      </mapping> 
    </element> 
    <element id="Measure.publisher">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <path value="Measure.publisher"/> 
      <short value="Name of the publisher/steward (organization or individual)"/> 
      <definition value="The name of the organization or individual responsible for the release and ongoing
       maintenance of the measure."/> 
      <comment value="Usually an organization but may be an individual. The publisher (or steward) of
       the measure is the organization or individual primarily responsible for the maintenance
       and upkeep of the measure. This is not necessarily the same individual or organization
       that developed and initially authored the content. The publisher is the primary
       point of contact for questions or issues with the measure. This item SHOULD be
       populated unless the information is available from context."/> 
      <requirements value="Helps establish the &quot;authority/credibility&quot; of the measure.  May also
       allow for contact."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.publisher"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.publisher"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.witness"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="participation[typeCode=AUT].role"/> 
      </mapping> 
    </element> 
    <element id="Measure.contact">
      <path value="Measure.contact"/> 
      <short value="Contact details for the publisher"/> 
      <definition value="Contact details to assist a user in finding and communicating with the publisher."/> 
      <comment value="May be a web site, an email address, a telephone number, etc.

See guidance around (not) making local changes to elements [here](canonicalresource.html#loca
      lization)."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.contact"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="ContactDetail"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.contact"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=CALLBCK].role"/> 
      </mapping> 
    </element> 
    <element id="Measure.description">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <path value="Measure.description"/> 
      <short value="Natural language description of the measure"/> 
      <definition value="A free text natural language description of the measure from a consumer's perspective."/> 
      <comment value="This description can be used to capture details such as comments about misuse,
       instructions for clinical use and interpretation, literature references, examples
       from the paper world, etc. It is not a rendering of the measure as conveyed in
       the 'text' field of the resource itself. This item SHOULD be populated unless the
       information is available from context (e.g. the language of the measure is presumed
       to be the predominant language in the place the measure was created)."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.description"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.description"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="Measure.useContext">
      <path value="Measure.useContext"/> 
      <short value="The context that the content is intended to support"/> 
      <definition value="The content was developed with a focus and intent of supporting the contexts that
       are listed. These contexts may be general categories (gender, age, ...) or may
       be references to specific programs (insurance plans, studies, ...) and may be used
       to assist with indexing and searching for appropriate measure instances."/> 
      <comment value="When multiple useContexts are specified, there is no expectation that all or any
       of the contexts apply."/> 
      <requirements value="Assist in searching for appropriate content."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.useContext"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="UsageContext"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.useContext"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.jurisdiction">
      <path value="Measure.jurisdiction"/> 
      <short value="Intended jurisdiction for measure (if applicable)"/> 
      <definition value="A legal or geographic region in which the measure is intended to be used."/> 
      <comment value="It may be possible for the measure to be used in jurisdictions other than those
       for which it was originally designed or intended.

DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to
       using the new 'jurisdiction' code in the useContext element.  (I.e. useContext.code
       indicating http://terminology.hl7.org/CodeSystem/usage-context-type#jurisdiction
       and useContext.valueCodeableConcept indicating the jurisdiction.)"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.jurisdiction"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Jurisdiction"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Countries and regions within which this artifact is targeted for use."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/jurisdiction"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.jurisdiction"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.purpose">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <path value="Measure.purpose"/> 
      <short value="Why this measure is defined"/> 
      <definition value="Explanation of why this measure is needed and why it has been designed as it has."/> 
      <comment value="This element does not describe the usage of the measure. Instead, it provides traceability
       of ''why'' the resource is either needed or ''why'' it is defined as it is.  This
       may be used to point to source materials or specifications that drove the structure
       of this measure."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.purpose"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.purpose"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.why[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".reasonCode.text"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Measure.usage">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <path value="Measure.usage"/> 
      <short value="Describes the clinical usage of the measure"/> 
      <definition value="A detailed description, from a clinical perspective, of how the measure is used."/> 
      <comment value="This metadata element was typically referred to as Guidance in HQMF"/> 
      <requirements value="Measure developers must be able to provide additional guidance for implementers
       to understand the intent with greater specificity than that provided in the population
       criteria of the measure. This element provides detailed guidance, where the usage
       element provides a summary of the guidance."/> 
      <alias value="guidance"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.usage"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.copyright">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <path value="Measure.copyright"/> 
      <short value="Use and/or publishing restrictions"/> 
      <definition value="A copyright statement relating to the measure and/or its contents. Copyright statements
       are generally legal restrictions on the use and publishing of the measure."/> 
      <comment value="The short copyright declaration (e.g. (c) '2015+ xyz organization' should be sent
       in the copyrightLabel element."/> 
      <requirements value="Consumers must be able to determine any legal restrictions on the use of the measure
       and/or its content."/> 
      <alias value="License"/> 
      <alias value="Restrictions"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.copyright"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.copyright"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Measure.copyrightLabel">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <path value="Measure.copyrightLabel"/> 
      <short value="Copyright holder and year(s)"/> 
      <definition value="A short string (&lt;50 characters), suitable for inclusion in a page footer that
       identifies the copyright holder, effective period, and optionally whether rights
       are resctricted. (e.g. 'All rights reserved', 'Some rights reserved')."/> 
      <comment value="The (c) symbol should NOT be included in this string. It will be added by software
       when rendering the notation. Full details about licensing, restrictions, warrantees,
       etc. goes in the more general 'copyright' element."/> 
      <requirements value="Defines the content expected to be rendered in all representations of the artifact."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.copyrightLabel"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.copyrightLabel"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Measure.approvalDate">
      <path value="Measure.approvalDate"/> 
      <short value="When the measure was approved by publisher"/> 
      <definition value="The date on which the resource content was approved by the publisher. Approval
       happens once when the content is officially approved for usage."/> 
      <comment value="The 'date' element may be more recent than the approval date because of minor changes
       or editorial corrections.

See guidance around (not) making local changes to elements [here](canonicalresource.html#loca
      lization)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.approvalDate"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="date"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.approvalDate"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=SUBJ].act[classCode=CACT;moodCode=EVN;code=&quot;approval&quot
        ;].effectiveTime"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Measure.lastReviewDate">
      <path value="Measure.lastReviewDate"/> 
      <short value="When the measure was last reviewed by the publisher"/> 
      <definition value="The date on which the resource content was last reviewed. Review happens periodically
       after approval but does not change the original approval date."/> 
      <comment value="If specified, this date follows the original approval date.

See guidance around (not) making local changes to elements [here](canonicalresource.html#loca
      lization)."/> 
      <requirements value="Gives a sense of how &quot;current&quot; the content is.  Resources that have not
       been reviewed in a long time may have a risk of being less appropriate/relevant."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.lastReviewDate"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="date"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.lastReviewDate"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRleationship[typeCode=SUBJ;subsetCode=RECENT].act[classCode=CACT;moodCode=EVN;code=r
        eview].effectiveTime"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Measure.effectivePeriod">
      <path value="Measure.effectivePeriod"/> 
      <short value="When the measure is expected to be used"/> 
      <definition value="The period during which the measure content was or is planned to be in active use."/> 
      <comment value="The effective period for a measure determines when the content is applicable for
       usage and is independent of publication and review dates. For example, a measure
       intended to be used for the year 2016 might be published in 2015.

See guidance around (not) making local changes to elements [here](canonicalresource.html#loca
      lization)."/> 
      <requirements value="Allows establishing a transition before a resource comes into effect and also allows
       for a sunsetting  process when new versions of the measure are or are expected
       to be used instead."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.effectivePeriod"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Period"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.effectivePeriod"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Measure.topic">
      <path value="Measure.topic"/> 
      <short value="The category of the measure, such as Education, Treatment, Assessment, etc"/> 
      <definition value="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
       searching."/> 
      <comment value="DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to
       using the new 'topic' code in the useContext element.  (I.e. useContext.code indicating
       http://terminology.hl7.org/CodeSystem/usage-context-type#topic and useContext.valueCodeableCo
      ncept indicating the topic)"/> 
      <requirements value="Repositories must be able to determine how to categorize the measure so that it
       can be found by topical searches."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.topic"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DefinitionTopic"/> 
        </extension> 
        <strength value="example"/> 
        <description value="High-level categorization of the definition, used for searching, sorting, and filtering."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/definition-topic"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.author">
      <path value="Measure.author"/> 
      <short value="Who authored the content"/> 
      <definition value="An individiual or organization primarily involved in the creation and maintenance
       of the content."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.author"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="ContactDetail"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT]"/> 
      </mapping> 
    </element> 
    <element id="Measure.editor">
      <path value="Measure.editor"/> 
      <short value="Who edited the content"/> 
      <definition value="An individual or organization primarily responsible for internal coherence of the
       content."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.editor"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="ContactDetail"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT] { not a great match, but there does not appear to
         be an editor concept in V3 participation }"/> 
      </mapping> 
    </element> 
    <element id="Measure.reviewer">
      <path value="Measure.reviewer"/> 
      <short value="Who reviewed the content"/> 
      <definition value="An individual or organization asserted by the publisher to be primarily responsible
       for review of some aspect of the content."/> 
      <comment value="See guidance around (not) making local changes to elements [here](canonicalresource.html#loca
      lization)."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.reviewer"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="ContactDetail"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=VRF] {not clear whether VRF best corresponds to reviewer
         or endorser}"/> 
      </mapping> 
    </element> 
    <element id="Measure.endorser">
      <path value="Measure.endorser"/> 
      <short value="Who endorsed the content"/> 
      <definition value="An individual or organization asserted by the publisher to be responsible for officially
       endorsing the content for use in some setting."/> 
      <comment value="See guidance around (not) making local changes to elements [here](canonicalresource.html#loca
      lization)."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.endorser"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="ContactDetail"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=VRF] {not clear whether VRF best corresponds to reviewer
         or endorser}"/> 
      </mapping> 
    </element> 
    <element id="Measure.relatedArtifact">
      <path value="Measure.relatedArtifact"/> 
      <short value="Additional documentation, citations, etc"/> 
      <definition value="Related artifacts such as additional documentation, justification, or bibliographic
       references."/> 
      <comment value="Each related artifact is either an attachment, or a reference to another resource,
       but not both."/> 
      <requirements value="Measures must be able to provide enough information for consumers of the content
       (and/or interventions or results produced by the content) to be able to determine
       and understand the justification for and evidence in support of the content."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.relatedArtifact"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="RelatedArtifact"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=DOC,RSON,PREV, DRIV, USE, COMP] {successor would
         be PREV w/ inversionInd=true; No support for citation}"/> 
      </mapping> 
    </element> 
    <element id="Measure.relatedArtifact.id">
      <path value="Measure.relatedArtifact.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Measure.relatedArtifact.extension">
      <path value="Measure.relatedArtifact.extension"/> 
      <slicing> 
        <discriminator> 
          <type value="value"/> 
          <path value="url"/> 
        </discriminator> 
        <description value="Extensions are always sliced by (at least) url"/> 
        <rules value="open"/> 
      </slicing> 
      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part
       of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Measure.relatedArtifact.type">
      <path value="Measure.relatedArtifact.type"/> 
      <short value="documentation | justification | citation | predecessor | successor | derived-from
       | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with
       | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects
       | correction-in | replaces | replaced-with | retracts | retracted-by | signs |
       similar-to | supports | supported-with | transforms | transformed-into | transformed-with
       | documents | specification-of | created-with | cite-as"/> 
      <definition value="The type of relationship to the related artifact."/> 
      <comment value="The presence of both sides of a relationship type (e.g. successor and predecessor)
       is required to support use cases where one side of a relationship is not represented
       in FHIR. However, this feature SHALL NOT be used to create bi-directional resource
       links in FHIR instances. Specifically, following the methodology of &quot;new points
       to old&quot; and &quot;many points to one&quot;, when using related artifact elements
       to describe and reference FHIR resources, the type element SHALL be drawn from
       the fhir-related-artifact-type ValueSet."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="RelatedArtifact.type"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="The type of relationship to the related artifact."/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="RelatedArtifactType"/> 
        </extension> 
        <strength value="required"/> 
        <description value="The type of relationship to the related artifact."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/related-artifact-type|5.0.0"/> 
      </binding> 
    </element> 
    <element id="Measure.relatedArtifact.classifier">
      <path value="Measure.relatedArtifact.classifier"/> 
      <short value="Additional classifiers"/> 
      <definition value="Provides additional classifiers of the related artifact."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="RelatedArtifact.classifier"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="Additional classifiers for the related artifact."/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="RelatedArtifactClassifier"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Additional classifiers for the related artifact."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/citation-artifact-classifier"/> 
      </binding> 
    </element> 
    <element id="Measure.relatedArtifact.label">
      <path value="Measure.relatedArtifact.label"/> 
      <short value="Short label"/> 
      <definition value="A short label that can be used to reference the citation from elsewhere in the
       containing artifact, such as a footnote index."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="RelatedArtifact.label"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Measure.relatedArtifact.display">
      <path value="Measure.relatedArtifact.display"/> 
      <short value="Brief description of the related artifact"/> 
      <definition value="A brief description of the document or knowledge resource being referenced, suitable
       for display to a consumer."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="RelatedArtifact.display"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Measure.relatedArtifact.citation">
      <path value="Measure.relatedArtifact.citation"/> 
      <short value="Bibliographic citation for the artifact"/> 
      <definition value="A bibliographic citation for the related artifact. This text SHOULD be formatted
       according to an accepted citation format."/> 
      <comment value="Additional structured information about citations should be captured as extensions."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="RelatedArtifact.citation"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Measure.relatedArtifact.document">
      <path value="Measure.relatedArtifact.document"/> 
      <short value="What document is being referenced"/> 
      <definition value="The document being referenced, represented as an attachment. This is exclusive
       with the resource element."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="RelatedArtifact.document"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Attachment"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Measure.relatedArtifact.resource">
      <path value="Measure.relatedArtifact.resource"/> 
      <short value="What artifact is being referenced"/> 
      <definition value="The related artifact, such as a library, value set, profile, or other knowledge
       resource."/> 
      <comment value="If the type is predecessor, this is a reference to the succeeding knowledge resource.
       If the type is successor, this is a reference to the prior knowledge resource."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="RelatedArtifact.resource"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="canonical"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Measure.relatedArtifact.resourceReference">
      <path value="Measure.relatedArtifact.resourceReference"/> 
      <short value="What artifact, if not a conformance resource"/> 
      <definition value="The related artifact, if the artifact is not a canonical resource, or a resource
       reference to a canonical resource."/> 
      <comment value="If both resource and resourceReference are present, they SHOULD be consistent and
       reference the same resource. Although relatedArtifact is intended to support references
       to definitional resources, there are cases where non-definitional resources can
       be definitional (such as Location where the kind is mode). Related artifacts SHOULD
       be used to reference definitional resources, and profiles SHOULD be used to make
       that explicit for particular use cases."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="RelatedArtifact.resourceReference"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Measure.relatedArtifact.publicationStatus">
      <path value="Measure.relatedArtifact.publicationStatus"/> 
      <short value="draft | active | retired | unknown"/> 
      <definition value="The publication status of the artifact being referred to."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="RelatedArtifact.publicationStatus"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="Publication status of an artifact being referred to."/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="RelatedArtifactPublicationStatus"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="required"/> 
        <description value="Publication status of an artifact being referred to."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/publication-status|5.0.0"/> 
      </binding> 
    </element> 
    <element id="Measure.relatedArtifact.publicationDate">
      <path value="Measure.relatedArtifact.publicationDate"/> 
      <short value="Date of publication of the artifact being referred to"/> 
      <definition value="The date of publication of the artifact being referred to."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="RelatedArtifact.publicationDate"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="date"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Measure.library">
      <path value="Measure.library"/> 
      <short value="Logic used by the measure"/> 
      <definition value="A reference to a Library resource containing the formal logic used by the measure."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.library"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="canonical"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Library"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.disclaimer">
      <path value="Measure.disclaimer"/> 
      <short value="Disclaimer for use of the measure or its referenced content"/> 
      <definition value="Notices and disclaimers regarding the use of the measure or related to intellectual
       property (such as code systems) referenced by the measure."/> 
      <requirements value="Some organizations require that notices and disclosures be included when publishing
       measures that reference their intellecutal property."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.disclaimer"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.scoring">
      <path value="Measure.scoring"/> 
      <short value="proportion | ratio | continuous-variable | cohort"/> 
      <definition value="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 represented."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.scoring"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MeasureScoring"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="The scoring type of the measure."/> 
        <valueSet value="http://terminology.hl7.org/ValueSet/measure-scoring"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".methodCode { the aspect of how the calculation is performed }"/> 
      </mapping> 
    </element> 
    <element id="Measure.scoringUnit">
      <path value="Measure.scoringUnit"/> 
      <short value="What units?"/> 
      <definition value="Defines the expected units of measure for the measure score. This element SHOULD
       be specified as a UCUM unit."/> 
      <comment value="When this element is specified, implementations are expected to report measure
       scores in the specified units. Note that this may involve unit conversion if the
       expected units are different than the units of the resulting score calculation.
       In this case, unit conversions SHALL be performed according to the unit conversion
       semantics specified by UCUM."/> 
      <requirements value="When the unit cannot be inferred directly from the calculation logic, this element
       allows the specification of the desired units of measure of the output."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.scoringUnit"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MeasureScoringUnit"/> 
        </extension> 
        <strength value="example"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/measure-scoring-unit"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".methodCode { the aspect of how the calculation is performed }"/> 
      </mapping> 
    </element> 
    <element id="Measure.compositeScoring">
      <path value="Measure.compositeScoring"/> 
      <short value="opportunity | all-or-nothing | linear | weighted"/> 
      <definition value="If this is a composite measure, the scoring method used to combine the component
       measures to determine the composite score."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.compositeScoring"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="CompositeMeasureScoring"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="The composite scoring method of the measure."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/composite-measure-scoring"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".methodCode { the aspect of how component measures are combined }"/> 
      </mapping> 
    </element> 
    <element id="Measure.type">
      <path value="Measure.type"/> 
      <short value="process | outcome | structure | patient-reported-outcome | composite"/> 
      <definition value="Indicates whether the measure is used to examine a process, an outcome over time,
       a patient-reported outcome, or a structure measure such as utilization."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.type"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MeasureType"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="The type of measure (includes codes from 2.16.840.1.113883.1.11.20368)."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/measure-type"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".methodCode { the aspect of what the measure applies to }"/> 
      </mapping> 
    </element> 
    <element id="Measure.riskAdjustment">
      <path value="Measure.riskAdjustment"/> 
      <short value="How risk adjustment is applied for this measure"/> 
      <definition value="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 results."/> 
      <comment value="Describes the method of adjusting for clinical severity and conditions present
       at the start of care that can influence patient outcomes for making valid comparisons
       of outcome measures across providers. Indicates whether a measure is subject to
       the statistical process for reducing, removing, or clarifying the influences of
       confounding factors to allow for more useful comparisons."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.riskAdjustment"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.rateAggregation">
      <path value="Measure.rateAggregation"/> 
      <short value="How is rate aggregation performed for this measure"/> 
      <definition value="Describes how to combine the information calculated, based on logic in each of
       several populations, into one summarized result."/> 
      <comment value="The measure rate for an organization or clinician is based upon the entities’ aggregate
       data and summarizes the performance of the entity over a given time period (e.g.,
       monthly, quarterly, yearly). The aggregated data are derived from the results of
       a specific measure algorithm and, if appropriate, the application of specific risk
       adjustment models.  Can also be used to describe how to risk adjust the data based
       on supplemental data elements described in the eMeasure (e.g., pneumonia hospital
       measures antibiotic selection in the ICU versus non-ICU and then the roll-up of
       the two). This could be applied to aggregated cohort measure definitions (e.g.,
       CDC's aggregate reporting for TB at the state level)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.rateAggregation"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.rationale">
      <path value="Measure.rationale"/> 
      <short value="Detailed description of why the measure exists"/> 
      <definition value="Provides a succinct statement of the need for the measure. Usually includes statements
       pertaining to importance criterion: impact, gap in care, and evidence."/> 
      <requirements value="Measure developers need to be able to provide a detailed description of the purpose
       of the measure. This element provides detailed rationale, where the purpose element
       provides a summary of the rationale."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.rationale"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.clinicalRecommendationStatement">
      <path value="Measure.clinicalRecommendationStatement"/> 
      <short value="Summary of clinical guidelines"/> 
      <definition value="Provides a summary of relevant clinical guidelines or other clinical recommendations
       supporting the measure."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.clinicalRecommendationStatement"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.improvementNotation">
      <path value="Measure.improvementNotation"/> 
      <short value="increase | decrease"/> 
      <definition value="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)."/> 
      <requirements value="Measure consumers and implementers must be able to determine how to interpret a
       measure score."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.improvementNotation"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MeasureImprovementNotation"/> 
        </extension> 
        <strength value="required"/> 
        <description value="Observation values that indicate what change in a measurement value or score is
         indicative of an improvement in the measured item or scored issue."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/measure-improvement-notation|5.0.0"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".interpretationCode"/> 
      </mapping> 
    </element> 
    <element id="Measure.term">
      <path value="Measure.term"/> 
      <short value="Defined terms used in the measure documentation"/> 
      <definition value="Provides a description of an individual term used within the measure."/> 
      <requirements value="Measure developers must be able to provide precise definitions of terms used within
       measure descriptions and guidance to help communicate the intent of the measure."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.term"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Measure.term.id">
      <path value="Measure.term.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Measure.term.extension">
      <path value="Measure.term.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part
       of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Measure.term.modifierExtension">
      <path value="Measure.term.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Measure.term.code">
      <path value="Measure.term.code"/> 
      <short value="What term?"/> 
      <definition value="A codeable representation of the defined term."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.term.code"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DefinitionCode"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Codeable representations of measure definition terms."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/measure-definition-example"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Measure.term.definition">
      <path value="Measure.term.definition"/> 
      <short value="Meaning of the term"/> 
      <definition value="Provides a definition for the term as used within the measure."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.term.definition"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.guidance">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="deprecated"/> 
      </extension> 
      <path value="Measure.guidance"/> 
      <short value="Additional guidance for implementers (deprecated)"/> 
      <definition value="Additional guidance for the measure including how it can be used in a clinical
       context, and the intent of the measure."/> 
      <comment value="NOTE: This element is deprecated in favor of the usage element"/> 
      <requirements value="Measure developers must be able to provide additional guidance for implementers
       to understand the intent with greater specificity than that provided in the population
       criteria of the measure. This element provides detailed guidance, where the usage
       element provides a summary of the guidance."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.guidance"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.group">
      <path value="Measure.group"/> 
      <short value="Population criteria group"/> 
      <definition value="A group of population criteria for the measure."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.group"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <condition value="mea-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP]"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.id">
      <path value="Measure.group.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.extension">
      <path value="Measure.group.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part
       of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.modifierExtension">
      <path value="Measure.group.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.linkId">
      <path value="Measure.group.linkId"/> 
      <short value="Unique id for group in measure"/> 
      <definition value="An identifier that is unique within the Measure allowing linkage to the equivalent
       item in a MeasureReport resource."/> 
      <comment value="This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended
       to have any meaning.  GUIDs or sequential numbers are appropriate here.

LinkIds can have whitespaces and slashes by design. Tooling should not rely on
       linkIds being valid XHTML element IDs, and should not directly embed them as such"/> 
      <requirements value="[MeasureReport](measurereport.html#) does not require omitted groups to be included."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.linkId"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="mea-2"/> 
        <severity value="warning"/> 
        <human value="Link ids should be 255 characters or less"/> 
        <expression value="$this.length() &lt;= 255"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Measure"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.code">
      <path value="Measure.group.code"/> 
      <short value="Meaning of the group"/> 
      <definition value="Indicates 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 measures."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.code"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MeasureGroupExample"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Example of measure groups."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/measure-group-example"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.description">
      <path value="Measure.group.description"/> 
      <short value="Summary description"/> 
      <definition value="The human readable description of this population group."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.description"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.type">
      <path value="Measure.group.type"/> 
      <short value="process | outcome | structure | patient-reported-outcome | composite"/> 
      <definition value="Indicates whether the measure is used to examine a process, an outcome over time,
       a patient-reported outcome, or a structure measure such as utilization."/> 
      <comment value="When specified at the group level, defines the measure type for this specific group.
       If not specified, the measureType of the group is determined by the root type element"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.group.type"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MeasureType"/> 
        </extension> 
        <strength value="extensible"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/measure-type"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".typeCode"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.subject[x]">
      <path value="Measure.group.subject[x]"/> 
      <short value="E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device"/> 
      <definition value="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 anything."/> 
      <comment value="The subject of the measure is critical in interpreting the criteria definitions,
       as the logic in the measures is evaluated with respect to a particular subject.
       This corresponds roughly to the notion of a Compartment in that it limits what
       content is available based on its relationship to the subject. In CQL, this corresponds
       to the context declaration."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.subject[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> 
      </type> 
      <meaningWhenMissing value="Patient"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="SubjectType"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="The possible types of subjects for a measure (E.g. Patient, Practitioner, Organization,
         Location, etc.)."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/participant-resource-types"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?) { only applies for subject Patient? }"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.basis">
      <path value="Measure.group.basis"/> 
      <short value="Population basis"/> 
      <definition value="The population basis specifies the type of elements in the population. For a subject-based
       measure, this is boolean (because the subject and the population basis are the
       same, and the population criteria define yes/no values for each individual in the
       population). For measures that have a population basis that is different than the
       subject, this element specifies the type of the population basis. For example,
       an encounter-based measure has a subject of Patient and a population basis of Encounter,
       and the population criteria all return lists of Encounters."/> 
      <comment value="When specified at the group level, defines the population basis for this specific
       group. If not specified, the basis for the group is determined by the root basis
       element"/> 
      <requirements value="Allows non-subject-based measures to be specified"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.basis"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <meaningWhenMissing value="boolean"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="BasisType"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="required"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/fhir-types|5.0.0"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?) { only applies for subject Patient? }"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.scoring">
      <path value="Measure.group.scoring"/> 
      <short value="proportion | ratio | continuous-variable | cohort"/> 
      <definition value="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 represented."/> 
      <comment value="When specified at the group level, defines the scoring for this specific group.
       If not specified, scoring for this group is determined by the root scoring element"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.scoring"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MeasureScoring"/> 
        </extension> 
        <strength value="extensible"/> 
        <valueSet value="http://terminology.hl7.org/ValueSet/measure-scoring"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".methodCode { the aspect of how the calculation is performed }"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.scoringUnit">
      <path value="Measure.group.scoringUnit"/> 
      <short value="What units?"/> 
      <definition value="Defines the expected units of measure for the measure score. This element SHOULD
       be specified as a UCUM unit."/> 
      <comment value="When specified at the group level, this defines the scoringUnit for this specific
       group. If not specified, the scoringUnit for this group is determined by the root
       scoringUnit element. As with the root element, when this element is specified,
       implementations are expected to report measure scores in the specified units. Note
       that this may involve unit conversion if the expected units are different than
       the units of the resulting score calculation. In this case, unit conversions SHALL
       be performed according to the unit conversion semantics specified by UCUM."/> 
      <requirements value="When the unit cannot be inferred directly from the calculation logic, this element
       allows the specification of the desired units of measure of the output."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.scoringUnit"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MeasureScoringUnit"/> 
        </extension> 
        <strength value="example"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/measure-scoring-unit"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".methodCode { the aspect of how the calculation is performed }"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.rateAggregation">
      <path value="Measure.group.rateAggregation"/> 
      <short value="How is rate aggregation performed for this measure"/> 
      <definition value="Describes how to combine the information calculated, based on logic in each of
       several populations, into one summarized result."/> 
      <comment value="The measure rate for an organization or clinician is based upon the entities’ aggregate
       data and summarizes the performance of the entity over a given time period (e.g.,
       monthly, quarterly, yearly). The aggregated data are derived from the results of
       a specific measure algorithm and, if appropriate, the application of specific risk
       adjustment models.  Can also be used to describe how to risk adjust the data based
       on supplemental data elements described in the eMeasure (e.g., pneumonia hospital
       measures antibiotic selection in the ICU versus non-ICU and then the roll-up of
       the two). This could be applied to aggregated cohort measure definitions (e.g.,
       CDC's aggregate reporting for TB at the state level)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.rateAggregation"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.improvementNotation">
      <path value="Measure.group.improvementNotation"/> 
      <short value="increase | decrease"/> 
      <definition value="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)."/> 
      <comment value="When specified at the group level, this element defines the improvementNotation
       for this specific group. If not specified, improvementNotation for this group is
       determined by the root improvementNotation element"/> 
      <requirements value="Measure consumers and implementers must be able to determine how to interpret a
       measure score."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.improvementNotation"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MeasureImprovementNotation"/> 
        </extension> 
        <strength value="required"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/measure-improvement-notation|5.0.0"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".methodCode { the aspect of how the calculation is performed }"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.library">
      <path value="Measure.group.library"/> 
      <short value="Logic used by the measure group"/> 
      <definition value="A reference to a Library resource containing the formal logic used by the measure
       group."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.group.library"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="canonical"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Library"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.population">
      <path value="Measure.group.population"/> 
      <short value="Population criteria"/> 
      <definition value="A population criteria for the measure."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.group.population"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP]"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.population.id">
      <path value="Measure.group.population.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.population.extension">
      <path value="Measure.group.population.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part
       of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.population.modifierExtension">
      <path value="Measure.group.population.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.population.linkId">
      <path value="Measure.group.population.linkId"/> 
      <short value="Unique id for population in measure"/> 
      <definition value="An identifier that is unique within the Measure allowing linkage to the equivalent
       population in a MeasureReport resource."/> 
      <comment value="This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended
       to have any meaning.  GUIDs or sequential numbers are appropriate here.

LinkIds can have whitespaces and slashes by design. Tooling should not rely on
       linkIds being valid XHTML element IDs, and should not directly embed them as such"/> 
      <requirements value="[MeasureReport](measurereport.html#) does not require omitted populations to be
       included."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.population.linkId"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="mea-3"/> 
        <severity value="warning"/> 
        <human value="Link ids should be 255 characters or less"/> 
        <expression value="$this.length() &lt;= 255"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Measure"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.population.code">
      <path value="Measure.group.population.code"/> 
      <short value="initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion
       | denominator-exception | measure-population | measure-population-exclusion | measure-observa
      tion"/> 
      <definition value="The type of population criteria."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.population.code"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MeasurePopulationType"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="The type of population."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/measure-population"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.population.description">
      <path value="Measure.group.population.description"/> 
      <short value="The human readable description of this population criteria"/> 
      <definition value="The human readable description of this population criteria."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.population.description"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.population.criteria">
      <path value="Measure.group.population.criteria"/> 
      <short value="The criteria that defines this population"/> 
      <definition value="An expression that specifies the criteria for the population, typically the name
       of an expression in a library."/> 
      <comment value="In the case of a continuous-variable or ratio measure, this may be the name of
       a function that calculates the value of the individual observation for each patient
       or event in the population. For these types of measures, individual observations
       are reported as observation resources included in the evaluatedResources bundle
       for each patient. See the MeasureReport resource or the Quality Reporting topic
       for more information."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.population.criteria"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Expression"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.population.groupDefinition">
      <path value="Measure.group.population.groupDefinition"/> 
      <short value="A group resource that defines this population"/> 
      <definition value="A Group resource that defines this population as a set of characteristics."/> 
      <comment value="Note that this approach can only be used for measures where the basis is of the
       same type as the populations (e.g. a Patient-based measure, rather than an Encounter-based
       measure). In addition, the referenced Group resource SHALL be a definitional (as
       opposed to an actual) group."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.population.groupDefinition"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.population.inputPopulationId">
      <path value="Measure.group.population.inputPopulationId"/> 
      <short value="Which population"/> 
      <definition value="The id of a population element in this measure that provides the input for this
       population criteria. In most cases, the scoring structure of the measure implies
       specific relationships (e.g. the Numerator uses the Denominator as the source in
       a proportion scoring). In some cases, however, multiple possible choices exist
       and must be resolved explicitly. For example in a ratio measure with multiple initial
       populations, the denominator must specify which population should be used as the
       starting point."/> 
      <requirements value="For ratio and continuous variable measures, the source populations must be specified
       explicitly when they cannot be unambiguously determined from the scoring structure."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.population.inputPopulationId"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.population.aggregateMethod">
      <path value="Measure.group.population.aggregateMethod"/> 
      <short value="Aggregation method for a measure score (e.g. sum, average, median, minimum, maximum,
       count)"/> 
      <definition value="Specifies which method should be used to aggregate measure observation values.
       For most scoring types, this is implied by scoring (e.g. a proportion measure counts
       members of the populations). For continuous variables, however, this information
       must be specified to ensure correct calculation."/> 
      <requirements value="For continuous variable measures, specifications must be able to indicate the aggregation
       method to be used for tallying results from individual observations."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.population.aggregateMethod"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MeasureAggregateMethod"/> 
        </extension> 
        <strength value="extensible"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/measure-aggregate-method"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.stratifier">
      <path value="Measure.group.stratifier"/> 
      <short value="Stratifier criteria for the measure"/> 
      <definition value="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
       Path."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.group.stratifier"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <condition value="mea-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP]"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.stratifier.id">
      <path value="Measure.group.stratifier.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.stratifier.extension">
      <path value="Measure.group.stratifier.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part
       of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.stratifier.modifierExtension">
      <path value="Measure.group.stratifier.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.stratifier.linkId">
      <path value="Measure.group.stratifier.linkId"/> 
      <short value="Unique id for stratifier in measure"/> 
      <definition value="An identifier that is unique within the Measure allowing linkage to the equivalent
       item in a MeasureReport resource."/> 
      <comment value="This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended
       to have any meaning.  GUIDs or sequential numbers are appropriate here.

LinkIds can have whitespaces and slashes by design. Tooling should not rely on
       linkIds being valid XHTML element IDs, and should not directly embed them as such"/> 
      <requirements value="[MeasureReport](measurereport.html#) does not require omitted stratifiers to be
       included."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.stratifier.linkId"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="mea-4"/> 
        <severity value="warning"/> 
        <human value="Link ids should be 255 characters or less"/> 
        <expression value="$this.length() &lt;= 255"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Measure"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.stratifier.code">
      <path value="Measure.group.stratifier.code"/> 
      <short value="Meaning of the stratifier"/> 
      <definition value="Indicates 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 measures."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.stratifier.code"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <condition value="mea-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MeasureStratifierExample"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Meaning of the stratifier."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/measure-stratifier-example"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.stratifier.description">
      <path value="Measure.group.stratifier.description"/> 
      <short value="The human readable description of this stratifier"/> 
      <definition value="The human readable description of this stratifier criteria."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.stratifier.description"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <condition value="mea-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.stratifier.criteria">
      <path value="Measure.group.stratifier.criteria"/> 
      <short value="How the measure should be stratified"/> 
      <definition value="An expression that specifies the criteria for the stratifier. This is typically
       the name of an expression defined within a referenced library, but it may also
       be a path to a stratifier element."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.stratifier.criteria"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Expression"/> 
      </type> 
      <condition value="mea-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.stratifier.groupDefinition">
      <path value="Measure.group.stratifier.groupDefinition"/> 
      <short value="A group resource that defines this population"/> 
      <definition value="A Group resource that defines this population as a set of characteristics."/> 
      <comment value="Note that this approach can only be used for measures where the basis is of the
       same type as the populations (e.g. a Patient-based measure, rather than an Encounter-based
       measure). In addition, the referenced Group SHALL be a definitional (as opposed
       to an actual) group."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.stratifier.groupDefinition"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.stratifier.component">
      <path value="Measure.group.stratifier.component"/> 
      <short value="Stratifier criteria component for the measure"/> 
      <definition value="A component of 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 Path."/> 
      <comment value="Stratifiers are defined either as a single criteria, or as a set of component criteria."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.group.stratifier.component"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <condition value="mea-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP]"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.stratifier.component.id">
      <path value="Measure.group.stratifier.component.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.stratifier.component.extension">
      <path value="Measure.group.stratifier.component.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part
       of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.stratifier.component.modifierExtension">
      <path value="Measure.group.stratifier.component.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.stratifier.component.linkId">
      <path value="Measure.group.stratifier.component.linkId"/> 
      <short value="Unique id for stratifier component in measure"/> 
      <definition value="An identifier that is unique within the Measure allowing linkage to the equivalent
       item in a MeasureReport resource."/> 
      <comment value="This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended
       to have any meaning.  GUIDs or sequential numbers are appropriate here.

LinkIds can have whitespaces and slashes by design. Tooling should not rely on
       linkIds being valid XHTML element IDs, and should not directly embed them as such"/> 
      <requirements value="[MeasureReport](measurereport.html#) does not require omitted stratifier components
       to be included."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.stratifier.component.linkId"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="mea-5"/> 
        <severity value="warning"/> 
        <human value="Link ids should be 255 characters or less"/> 
        <expression value="$this.length() &lt;= 255"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Measure"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.stratifier.component.code">
      <path value="Measure.group.stratifier.component.code"/> 
      <short value="Meaning of the stratifier component"/> 
      <definition value="Indicates a meaning for the stratifier component. 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 measures."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.stratifier.component.code"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MeasureStratifierExample"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Meaning of the stratifier."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/measure-stratifier-example"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.stratifier.component.description">
      <path value="Measure.group.stratifier.component.description"/> 
      <short value="The human readable description of this stratifier component"/> 
      <definition value="The human readable description of this stratifier criteria component."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.stratifier.component.description"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.stratifier.component.criteria">
      <path value="Measure.group.stratifier.component.criteria"/> 
      <short value="Component of how the measure should be stratified"/> 
      <definition value="An expression that specifies the criteria for this component of the stratifier.
       This is typically the name of an expression defined within a referenced library,
       but it may also be a path to a stratifier element."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.stratifier.component.criteria"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Expression"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.group.stratifier.component.groupDefinition">
      <path value="Measure.group.stratifier.component.groupDefinition"/> 
      <short value="A group resource that defines this population"/> 
      <definition value="A Group resource that defines this population as a set of characteristics."/> 
      <comment value="Note that this approach can only be used for measures where the basis is of the
       same type as the populations (e.g. a Patient-based measure, rather than an Encounter-based
       measure). In addition, the referenced Group SHALL be a definitional (as opposed
       to an actual) group."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.group.stratifier.component.groupDefinition"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Measure.supplementalData">
      <path value="Measure.supplementalData"/> 
      <short value="What other data should be reported with the measure"/> 
      <definition value="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
       Path."/> 
      <comment value="Note that supplemental data are reported as resources for each patient and referenced
       in the supplementalData element of the MeasureReport. If the supplementalData expression
       results in a value other than a resource, it is reported using an Observation resource,
       typically contained in the resulting MeasureReport. See the MeasureReport resource
       and the Quality Reporting topic for more information."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.supplementalData"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP]"/> 
      </mapping> 
    </element> 
    <element id="Measure.supplementalData.id">
      <path value="Measure.supplementalData.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Measure.supplementalData.extension">
      <path value="Measure.supplementalData.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part
       of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Measure.supplementalData.modifierExtension">
      <path value="Measure.supplementalData.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Measure.supplementalData.linkId">
      <path value="Measure.supplementalData.linkId"/> 
      <short value="Unique id for supplementalData in measure"/> 
      <definition value="An identifier that is unique within the Measure allowing linkage to the equivalent
       item in a MeasureReport resource."/> 
      <comment value="This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended
       to have any meaning.  GUIDs or sequential numbers are appropriate here.

LinkIds can have whitespaces and slashes by design. Tooling should not rely on
       linkIds being valid XHTML element IDs, and should not directly embed them as such"/> 
      <requirements value="[MeasureReport](measurereport.html#) does not require omitted supplementalData
       to be included."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.supplementalData.linkId"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="mea-6"/> 
        <severity value="warning"/> 
        <human value="Link ids should be 255 characters or less"/> 
        <expression value="$this.length() &lt;= 255"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Measure"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
    </element> 
    <element id="Measure.supplementalData.code">
      <path value="Measure.supplementalData.code"/> 
      <short value="Meaning of the supplemental data"/> 
      <definition value="Indicates 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 measures."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.supplementalData.code"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MeasureSupplementalDataExample"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Meaning of the supplemental data."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/measure-supplemental-data-example"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="Measure.supplementalData.usage">
      <path value="Measure.supplementalData.usage"/> 
      <short value="supplemental-data | risk-adjustment-factor"/> 
      <definition value="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
       calculation."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Measure.supplementalData.usage"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MeasureDataUsage"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="The intended usage for supplemental data elements in the measure."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/measure-data-usage"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".methodCode"/> 
      </mapping> 
    </element> 
    <element id="Measure.supplementalData.description">
      <path value="Measure.supplementalData.description"/> 
      <short value="The human readable description of this supplemental data"/> 
      <definition value="The human readable description of this supplemental data."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.supplementalData.description"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="Measure.supplementalData.criteria">
      <path value="Measure.supplementalData.criteria"/> 
      <short value="Expression describing additional data to be reported"/> 
      <definition value="The criteria for the supplemental data. This is typically the name of a valid expression
       defined within a referenced library, but it may also be a path to a specific data
       element. The criteria defines the data to be returned for this element."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Measure.supplementalData.criteria"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Expression"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
  </snapshot> 
  <differential> 
    <element id="Measure">
      <path value="Measure"/> 
      <min value="1"/> 
      <max value="1"/> 
    </element> 
    <element id="Measure.identifier">
      <path value="Measure.identifier"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.date">
      <path value="Measure.date"/> 
      <min value="1"/> 
      <max value="1"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.contact">
      <path value="Measure.contact"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.useContext">
      <path value="Measure.useContext"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.jurisdiction">
      <path value="Measure.jurisdiction"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.purpose">
      <path value="Measure.purpose"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.usage">
      <path value="Measure.usage"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.copyright">
      <path value="Measure.copyright"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.copyrightLabel">
      <path value="Measure.copyrightLabel"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.approvalDate">
      <path value="Measure.approvalDate"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.lastReviewDate">
      <path value="Measure.lastReviewDate"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.effectivePeriod">
      <path value="Measure.effectivePeriod"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.topic">
      <path value="Measure.topic"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.author">
      <path value="Measure.author"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.editor">
      <path value="Measure.editor"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.reviewer">
      <path value="Measure.reviewer"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.endorser">
      <path value="Measure.endorser"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.relatedArtifact">
      <path value="Measure.relatedArtifact"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.relatedArtifact.display">
      <path value="Measure.relatedArtifact.display"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.relatedArtifact.document">
      <path value="Measure.relatedArtifact.document"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.relatedArtifact.resource">
      <path value="Measure.relatedArtifact.resource"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Measure.relatedArtifact.resourceReference">
      <path value="Measure.relatedArtifact.resourceReference"/> 
      <mustSupport value="true"/> 
    </element> 
  </differential> 
</StructureDefinition>