Quality Measure STU2 for FHIR R4 Implementation Guide
This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v1.1.0: STU 2 Ballot 1) based on FHIR R4. The current version which supercedes this version is 3.0.0. For a full list of available versions, see the Directory of published versions 
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"meta" : {
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"lastUpdated" : "2019-11-06T23:55:48.200+00:00",
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table style=\"width: 60%; border-bottom: none;\" class=\"header_table\">\n \n <tr style=\"vertical-align: top;\">\n <td scope=\"row\" style=\"background-color:#656565; width:20%\">\n <span class=\"td_label\">Measure Title</span>\n </td>\n <td colspan=\"1\" style=\"width:60%\">\n <h1 style=\"font-size:10px\">EXM Measure</h1>\n </td>\n <td scope=\"row\" style=\"background-color:#656565; width:10%\">\n <span class=\"td_label\">Measure ID</span>\n </td>\n <td colspan=\"1\" style=\"width:10%\">\n <h1 style=\"font-size:10px\">MeasureEXM</h1>\n </td>\n </tr>\n \n<tr style=\"vertical-align: top;\">\n <td scope=\"row\" style=\"background-color:#656565; width:20%\">\n <span class=\"td_label\">Description</span>\n </td>\n <td colspan=\"3\" style=\"width:80%\">\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n <pre>\n <p>An example FHIR-based measure</p>\n </pre>\n </div>\n </td>\n</tr>\n<tr>\n <td scope=\"row\" style=\"background-color:#656565; width:20%\">\n <span class=\"td_label\">Measurement Period</span>\n </td>\n <td colspan=\"3\" style=\"width:80%\">January 1 - December 31</td>\n</tr>\n\n\n<tr>\n <td scope=\"row\" style=\"background-color:#656565; width:20%\">\n <span class=\"td_label\">Copyright and Disclaimer Notice</span>\n </td>\n <td colspan=\"3\" style=\"width:80%\">\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n <pre>Example disclaimer</pre>\n <br/>\n <pre>Example Copyright Statement</pre>\n </div>\n </td>\n</tr>\n<tr>\n <td scope=\"row\" style=\"background-color:#656565; width:20%\">\n <span class=\"td_label\">Clinical Recommendation Statement</span>\n </td>\n <td colspan=\"3\" style=\"width:80%\">\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n <p>The clinical recommendation statement for this measure is...</p>\n </div>\n </td>\n</tr>\n<tr>\n <td colspan=\"4\" scope=\"row\" style=\"background-color:#656565; width:100%\">\n <span class=\"td_label\">Characteristics</span>\n </td>\n</tr>\n<tr>\n <td scope=\"row\" style=\"width:20%\">\n <span>Scoring</span>\n </td>\n <td colspan=\"3\" style=\"width:80%\">Proportion</td>\n</tr>\n\n<tr style=\"vertical-align: top;\">\n <td rowspan=\"1\" scope=\"row\" style=\"width:20%\">\n <span>Type</span>\n </td>\n <td colspan=\"3\" style=\"width:80%\">Process</td>\n</tr>\n\n\n<tr>\n <td scope=\"row\" style=\"width:20%\">\n <span>Risk Adjustment</span>\n </td>\n <td colspan=\"3\" style=\"width:80%\">\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n <pre>Risk adjustment for this measure is performed by...</pre>\n </div>\n </td>\n</tr>\n\n<tr>\n <td scope=\"row\" style=\"width:20%\">\n <span>Improvement Notation</span>\n </td>\n <td colspan=\"3\" style=\"width:80%\">A higher rate indicates better performance.</td>\n</tr>\n<tr>\n <td scope=\"row\" style=\"width:20%\">\n <span>Guidance</span>\n </td>\n <td colspan=\"3\" style=\"width:80%\">\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\n <p>Additional guidance provided to help communicate the intent of the measure</p>\n </div>\n </td>\n</tr>\n<tr>\n <td colspan=\"4\" scope=\"row\" style=\"background-color:#656565; width:100%\">\n <span class=\"td_label\">Definitions</span>\n </td>\n</tr>\n<tr>\n \n <td colspan=\"4\" style=\"width:100%\">\n <div style=\"width:880px;overflow-x:hidden;overflow-y:auto\">\n <p>A term used in the measure that bears clearly defining to communicate the measure intent</p>\n </div>\n </td>\n</tr>\n\n\n</table>\n<table style=\"width: 60%; border-top: none; border-bottom: none\" class=\"header_table\">\n <tr style=\"vertical-align: top;\">\n <td rowspan=\"3\" scope=\"row\" style=\"background-color:#656565; width:20%\">\n <span class=\"td_label\">Population Criteria 1</span>\n </td>\n <td style=\"width:20%;\">\n <span style=\"font-size:10px; font-weight: bold;\">Initial Population</span>\n </td>\n <td colspan=\"2\" style=\"width:60%;\">\n <div style=\"overflow-x:hidden;overflow-y:auto\">\n <pre/>\n </div>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"width:20%;\">\n <span style=\"font-size:10px; font-weight: bold;\">Numerator</span>\n </td>\n <td colspan=\"2\" style=\"width:60%;\">\n <div style=\"overflow-x:hidden;overflow-y:auto\">\n <pre/>\n </div>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"width:20%;\">\n <span style=\"font-size:10px; font-weight: bold;\">Denominator</span>\n </td>\n <td colspan=\"2\" style=\"width:60%;\">\n <div style=\"overflow-x:hidden;overflow-y:auto\">\n <pre/>\n </div>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td rowspan=\"3\" scope=\"row\" style=\"background-color:#656565; width:20%\">\n <span class=\"td_label\">Population Criteria 2</span>\n </td>\n <td style=\"width:20%;\">\n <span style=\"font-size:10px; font-weight: bold;\">Initial Population</span>\n </td>\n <td colspan=\"2\" style=\"width:60%;\">\n <div style=\"overflow-x:hidden;overflow-y:auto\">\n <pre/>\n </div>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"width:20%;\">\n <span style=\"font-size:10px; font-weight: bold;\">Numerator</span>\n </td>\n <td colspan=\"2\" style=\"width:60%;\">\n <div style=\"overflow-x:hidden;overflow-y:auto\">\n <pre/>\n </div>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"width:20%;\">\n <span style=\"font-size:10px; font-weight: bold;\">Denominator</span>\n </td>\n <td colspan=\"2\" style=\"width:60%;\">\n <div style=\"overflow-x:hidden;overflow-y:auto\">\n <pre/>\n </div>\n </td>\n </tr>\n</table>\n<table style=\"width: 60%; border-top: none;\" class=\"header_table\">\n \n\n\n</table>\n<h2>\n <a name=\"toc\">Table of Contents</a>\n</h2>\n<ul style=\"padding-left: 50px;\">\n <li>\n <a href=\"#d1e405\">Population Criteria</a>\n </li>\n <li>\n <a href=\"#d1e649\">Definitions</a>\n </li>\n <li>\n <a href=\"#d1e650\">Functions</a>\n </li>\n <li>\n <a href=\"#d1e555\">Terminology</a>\n </li>\n <li>\n <a href=\"#d1e647\">Data Criteria (QDM Data Elements)</a>\n </li>\n <li>\n <a href=\"#d1e767\">Supplemental Data Elements</a>\n </li>\n <li>\n <a href=\"#d1e879\">Risk Adjustment Variables</a>\n </li>\n</ul>\n<div style=\"float:left; background:teal; height:3px; width:80%\"/>\n<pre>\n <br/>\n</pre>\n<h3>\n <a name=\"d1e405\" href=\"#toc\">Population Criteria 1</a>\n</h3>\n<div>\n <ul style=\"list-style:none;padding-left:10px;\">\n <li style=\"list-style:none;padding-left:0px;\" class=\"list-unstyled\">\n <div class=\"treeview hover p-l-10\"> </div>\n <div class=\"treeview hover p-l-10\"> </div>\n <div class=\"treeview hover p-l-10\"> </div>\n <div class=\"treeview hover p-l-10\">\n <ul class=\"list-unstyled\">\n <li class=\"list-unstyled\">\n <strong>Stratifier 1</strong>\n <ul class=\"code\">\n <li class=\"list-unstyled\">\n <div class=\"treeview hover p-l-10\">\n <ul>\n <li style=\"padding-left: 0px;\">\n <div>\n <pre class=\"cql-definition-body\">Stratifier 1</pre>\n </div>\n </li>\n </ul>\n </div>\n </li>\n </ul>\n </li>\n </ul>\n </div>\n <div class=\"treeview hover p-l-10\">\n <ul class=\"list-unstyled\">\n <li class=\"list-unstyled\">\n <strong>Stratifier 2</strong>\n <ul class=\"code\">\n <li class=\"list-unstyled\">\n <div class=\"treeview hover p-l-10\">\n <ul>\n <li style=\"padding-left: 0px;\">\n <div>\n <pre class=\"cql-definition-body\">Stratifier 2</pre>\n </div>\n </li>\n </ul>\n </div>\n </li>\n </ul>\n </li>\n </ul>\n </div>\n <div class=\"treeview hover p-l-10\">\n <ul class=\"list-unstyled\">\n <li class=\"list-unstyled\">\n <strong>Stratifier 3</strong>\n <ul class=\"code\">\n <li class=\"list-unstyled\">\n <div class=\"treeview hover p-l-10\">\n <ul>\n <li style=\"padding-left: 0px;\">\n <div>\n <pre class=\"cql-definition-body\">Stratifier 3</pre>\n </div>\n </li>\n </ul>\n </div>\n </li>\n </ul>\n </li>\n </ul>\n </div>\n <div class=\"treeview hover p-l-10\">\n <ul class=\"list-unstyled\">\n <li class=\"list-unstyled\">\n <strong>Stratifier 4</strong>\n <ul class=\"code\">\n <li class=\"list-unstyled\">\n <div class=\"treeview hover p-l-10\">\n <ul>\n <li style=\"padding-left: 0px;\">\n <div>\n <pre class=\"cql-definition-body\">Stratifier 4</pre>\n </div>\n </li>\n </ul>\n </div>\n </li>\n </ul>\n </li>\n </ul>\n </div>\n </li>\n </ul>\n</div>\n<pre>\n <br/>\n</pre>\n<h3>\n <a name=\"d1e405\" href=\"#toc\">Population Criteria 2</a>\n</h3>\n<div>\n <ul style=\"list-style:none;padding-left:10px;\">\n <li style=\"list-style:none;padding-left:0px;\" class=\"list-unstyled\">\n <div class=\"treeview hover p-l-10\"> </div>\n <div class=\"treeview hover p-l-10\"> </div>\n <div class=\"treeview hover p-l-10\"> </div>\n <div class=\"treeview hover p-l-10\">\n <ul class=\"list-unstyled\">\n <li class=\"list-unstyled\">\n <strong>Stratifier 1</strong>\n <ul class=\"code\">\n <li class=\"list-unstyled\">\n <div class=\"treeview hover p-l-10\">\n <ul>\n <li style=\"padding-left: 0px;\">\n <div>\n <pre class=\"cql-definition-body\">Stratifier 1</pre>\n </div>\n </li>\n </ul>\n </div>\n </li>\n </ul>\n </li>\n </ul>\n </div>\n <div class=\"treeview hover p-l-10\">\n <ul class=\"list-unstyled\">\n <li class=\"list-unstyled\">\n <strong>Stratifier 2</strong>\n <ul class=\"code\">\n <li class=\"list-unstyled\">\n <div class=\"treeview hover p-l-10\">\n <ul>\n <li style=\"padding-left: 0px;\">\n <div>\n <pre class=\"cql-definition-body\">Stratifier 2</pre>\n </div>\n </li>\n </ul>\n </div>\n </li>\n </ul>\n </li>\n </ul>\n </div>\n <div class=\"treeview hover p-l-10\">\n <ul class=\"list-unstyled\">\n <li class=\"list-unstyled\">\n <strong>Stratifier 3</strong>\n <ul class=\"code\">\n <li class=\"list-unstyled\">\n <div class=\"treeview hover p-l-10\">\n <ul>\n <li style=\"padding-left: 0px;\">\n <div>\n <pre class=\"cql-definition-body\">Stratifier 3</pre>\n </div>\n </li>\n </ul>\n </div>\n </li>\n </ul>\n </li>\n </ul>\n </div>\n <div class=\"treeview hover p-l-10\">\n <ul class=\"list-unstyled\">\n <li class=\"list-unstyled\">\n <strong>Stratifier 4</strong>\n <ul class=\"code\">\n <li class=\"list-unstyled\">\n <div class=\"treeview hover p-l-10\">\n <ul>\n <li style=\"padding-left: 0px;\">\n <div>\n <pre class=\"cql-definition-body\">Stratifier 4</pre>\n </div>\n </li>\n </ul>\n </div>\n </li>\n </ul>\n </li>\n </ul>\n </div>\n </li>\n </ul>\n</div>\n<h3>\n <a name=\"d1e649\" href=\"#toc\">Definitions</a>\n</h3>\n<h3>\n <a name=\"d1e650\" href=\"#toc\">Functions</a>\n</h3>\n<h3>\n <a name=\"d1e555\" href=\"#toc\">Terminology</a>\n</h3>\n<div>\n <ul style=\"padding-left: 50px;\"> </ul>\n</div>\n<h3>\n <a name=\"d1e647\" href=\"#toc\">Data Criteria (QDM Data Elements)</a>\n</h3>\n<div>\n <ul style=\"padding-left: 50px;\"> </ul>\n</div>\n<h3>\n <a name=\"d1e767\" href=\"#toc\">Supplemental Data Elements</a>\n</h3>\n<div>\n <ul style=\"list-style:none;padding-left: 25px;\">\n <li>None</li>\n </ul>\n</div>\n<h3>\n <a name=\"d1e879\" href=\"#toc\">Risk Adjustment Variables</a>\n</h3>\n<div>\n <ul style=\"list-style:none;padding-left: 25px;\">\n <li>None</li>\n </ul>\n</div>\n<div style=\"float:left; background:teal; height:3px; width:80%\"/>\n<table>\n \n</table>\n</div>"
},
"extension" : [
{
"extension" : [
{
"url" : "type",
"valueCode" : "documentation"
},
{
"url" : "text",
"valueString" : "This illustrates an example comment"
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-artifactComment"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
"valueCode" : "boolean"
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{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-allocation",
"valueMarkdown" : "Additional guidance for allocation"
}
],
"url" : "http://example.org/fhir/measures/measure-exm",
"identifier" : [
{
"system" : "http://example.org/fhir/cqi/ecqm/Measure/Identifier/exm",
"value" : "EXM"
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"version" : "1.1.0",
"name" : "MeasureEXM",
"title" : "EXM Measure",
"status" : "active",
"experimental" : true,
"date" : "2019-02-17T00:00:00+00:00",
"publisher" : "Example Measure Publisher",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "http://www.example.org/"
}
]
}
],
"description" : "An example FHIR-based measure",
"useContext" : [
{
"code" : {
"code" : "program"
},
"valueCodeableConcept" : {
"text" : "eligible-provider"
}
}
],
"jurisdiction" : [
{
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "US",
"display" : "United States of America"
}
]
}
],
"purpose" : "The purpose of this measure is to...",
"usage" : "Users of this measure should be aware of...",
"copyright" : "Example Copyright Statement",
"approvalDate" : "2019-02-17",
"lastReviewDate" : "2019-02-17",
"effectivePeriod" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodAnchor",
"valueDateTime" : "2018-01-01T00:00:00+00:00"
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{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodDuration",
"valueDuration" : {
"value" : 1,
"system" : "http://unitsofmeasure.org",
"code" : "a"
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"start" : "2018-01-01T00:00:00+00:00",
"end" : "2018-12-31T00:00:00+00:00"
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"topic" : [
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"coding" : [
{
"system" : "http://loinc.org",
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"text" : "Health Quality Measure Document"
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"name" : "Example Measure Content Developer"
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"relatedArtifact" : [
{
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"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isPrimaryCitation",
"valueBoolean" : true
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"type" : "documentation",
"citation" : "Linder, J.A., D.W. Bates, G.M. Lee, J.A. Finkelstein. 2005. \"Antibiotic treatment of children with sore throat.\" JAMA 294(18):2315-2322."
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{
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"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isPrimaryCitation",
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"type" : "documentation",
"citation" : "Infectious Diseases Society of America. 2012. \"Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update.\""
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{
"extension" : [
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"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isPrimaryCitation",
"valueBoolean" : true
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"type" : "documentation",
"citation" : "Roberts, R.R., B. Hota, I. Ahmad, et al. \"Hospital and Societal Costs of Antimicrobial-Resistant Infections in a Chicago Teaching Hospital: Implications for Antibiotic Stewardship.\" Clin Infect Dis. Oct 2009; 49(8):1175-84."
}
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"library" : [
"http://hl7.org/fhir/us/cqfmeasures/Library/exm-logic"
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"disclaimer" : "Example disclaimer",
"scoring" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code" : "proportion",
"display" : "Proportion"
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]
},
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-type",
"code" : "process"
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]
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],
"riskAdjustment" : "Risk adjustment for this measure is performed by...",
"rateAggregation" : "Rate aggregation for this measure is performed by...",
"rationale" : "Rationale for this measure is...",
"clinicalRecommendationStatement" : "The clinical recommendation statement for this measure is...",
"improvementNotation" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code" : "increase",
"display" : "Increased score indicates improvement"
}
]
},
"_definition" : [
{
"extension" : [
{
"extension" : [
{
"url" : "term",
"valueString" : "Term"
},
{
"url" : "definition",
"valueMarkdown" : "A term used in the measure that bears clearly definition to communicate the measure intent"
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-definitionTerm"
}
]
}
],
"guidance" : "Additional guidance provided to help communicate the intent of the measure",
"group" : [
{
"id" : "group-1",
"population" : [
{
"id" : "initial-population-1",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
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"language" : "text/cql",
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{
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"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
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"language" : "text/cql",
"expression" : "Numerator 1"
}
},
{
"id" : "denominator-1",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"criteria" : {
"language" : "text/cql",
"expression" : "Denominator 1"
}
}
],
"stratifier" : [
{
"id" : "stratifier-1-1",
"criteria" : {
"language" : "text/cql",
"expression" : "Stratifier 1-1"
}
},
{
"id" : "stratifier-1-2",
"criteria" : {
"language" : "text/cql",
"expression" : "Stratifier 1-2"
}
},
{
"id" : "stratifier-1-3",
"criteria" : {
"language" : "text/cql",
"expression" : "Stratifier 1-3"
}
},
{
"id" : "stratifier-1-4",
"criteria" : {
"language" : "text/cql",
"expression" : "Stratifier 1-4"
}
}
]
},
{
"id" : "group-2",
"population" : [
{
"id" : "initial-population-2",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
},
"criteria" : {
"language" : "text/cql",
"expression" : "Initial Population 2"
}
},
{
"id" : "numerator-2",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
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"criteria" : {
"language" : "text/cql",
"expression" : "Numerator 2"
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},
{
"id" : "denominator-2",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"criteria" : {
"language" : "text/cql",
"expression" : "Denominator 2"
}
}
],
"stratifier" : [
{
"id" : "stratifier-2-1",
"criteria" : {
"language" : "text/cql",
"expression" : "Stratifier 2-1"
}
},
{
"id" : "stratifier-2-2",
"criteria" : {
"language" : "text/cql",
"expression" : "Stratifier 2-2"
}
},
{
"id" : "stratifier-2-3",
"criteria" : {
"language" : "text/cql",
"expression" : "Stratifier 2-3"
}
},
{
"id" : "stratifier-2-4",
"criteria" : {
"language" : "text/cql",
"expression" : "Stratifier 2-4"
}
}
]
}
],
"supplementalData" : [
{
"id" : "sde-ethnicity",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
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]
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],
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"language" : "text/cql",
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}
},
{
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{
"coding" : [
{
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"code" : "supplemental-data"
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]
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},
{
"id" : "sde-payer",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
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}
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"language" : "text/cql",
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},
{
"id" : "sde-sex",
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"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"criteria" : {
"language" : "text/cql",
"expression" : "SDE Sex"
}
}
]
}
© HL7.org (Clinical Quality Information WG). hl7.fhir.us.cqfmeasures#1.1.0 based on FHIR v4.0.1 generated 24/12/2019.
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