Name	Flags	Card.	Type	Description & Constraints
Measure		1..1	CQFMMeasure	A quality measure definition
scoringUnit	S	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
Slices for relatedArtifact	S	0..*	RelatedArtifact	Additional documentation, citations, etc. Slice: Unordered, Open by value:type
relatedArtifact:component	S	0..*	RelatedArtifact	Additional documentation, citations, etc.
groupId	S	0..1	string	What group URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-groupId
weight	S	0..1	decimal	Contribution? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight
type	S	1..1	code	Component measure Fixed Value: composed-of
display	S	0..1	string	Brief description of the related artifact
resource	S	1..1	canonical(Measure)	What resource is being referenced
compositeScoring	S	0..1	CodeableConcept	opportunity | all-or-nothing | linear | weighted Binding: CompositeMeasureScoring (extensible)
group	S	0..*	BackboneElement	Population criteria group
compositeScoring	S	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
scoringUnit	S	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
component	S	0..*	RelatedArtifact	What artifact URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component
groupId	S	0..1	string	What group URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-groupId
weight	S	0..1	decimal	Contribution? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Measure.compositeScoring	extensible	CompositeMeasureScoring

Name	Flags	Card.	Type	Description & Constraints
Measure	C	1..1	CQFMMeasure	A quality measure definition
meta	SΣ	1..1	Meta	Metadata about the resource
profile	SΣ	1..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
comment	S	0..*	(Complex)	Additional documentation, review, or usage guidance URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-artifactComment
allocation	S	0..1	markdown	Allocation guidance URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-allocation
softwaresystem	S	0..*	Reference(CQFM Device)	Extension URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem
scoringUnit	S	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
url	Σ	1..1	uri	Canonical identifier for this measure, represented as a URI (globally unique)
identifier	SΣ	0..*	Identifier	Additional identifier for the measure
version	Σ	1..1	string	Business version of the measure
name	ΣC	1..1	string	Name for this measure (computer friendly)
title	SΣ	0..1	string	Name for this measure (human friendly)
status	?!Σ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
experimental	Σ	1..1	boolean	For testing purposes, not real usage
date	SΣ	0..1	dateTime	Date last changed
publisher	Σ	1..1	string	Name of the publisher (organization or individual)
contact	SΣ	0..*	ContactDetail	Contact details for the publisher
description	Σ	1..1	markdown	Natural language description of the measure
useContext	SΣ	0..*	UsageContext	The context that the content is intended to support
jurisdiction	SΣ	0..*	CodeableConcept	Intended jurisdiction for measure (if applicable) Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.
Slices for relatedArtifact	S	0..*	RelatedArtifact	Additional documentation, citations, etc. Slice: Unordered, Open by value:type
relatedArtifact:component	S	0..*	RelatedArtifact	Additional documentation, citations, etc.
groupId	S	0..1	string	What group URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-groupId
weight	S	0..1	decimal	Contribution? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight
type	SΣ	1..1	code	Component measure Binding: RelatedArtifactType (required): The type of relationship to the related artifact. Fixed Value: composed-of
display	SΣ	0..1	string	Brief description of the related artifact
resource	SΣ	1..1	canonical(Measure)	What resource is being referenced
library	SC	0..1	canonical(CQFM Library)	CQFMMeasures are not required to use a Library, but if they do, it SHALL be a CQFMLibrary.
compositeScoring	SΣ	0..1	CodeableConcept	opportunity | all-or-nothing | linear | weighted Binding: CompositeMeasureScoring (extensible)
type	SΣ	0..*	CodeableConcept	process | outcome | structure | patient-reported-outcome | composite Binding: MeasureType (extensible)
group	S	0..*	BackboneElement	Population criteria group
id	SC	0..1	string	Unique id for inter-element referencing
compositeScoring	S	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
scoringUnit	S	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
component	S	0..*	RelatedArtifact	What artifact URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component
groupId	S	0..1	string	What group URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-groupId
weight	S	0..1	decimal	Contribution? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight
url		1..1	uri	"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component"
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
population	S	0..*	BackboneElement	Population criteria
id	S	1..1	string	Unique id for inter-element referencing
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible)
criteria	SC	1..1	Expression	The criteria that defines this population
stratifier	S	0..*	BackboneElement	Stratifier criteria for the measure
id	S	1..1	string	Unique id for inter-element referencing
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
criteria	SC	0..1	Expression	How the measure should be stratified
supplementalData	SC	0..*	BackboneElement	What other data should be reported with the measure
id	S	1..1	string	Unique id for inter-element referencing
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the supplemental data Binding: MeasureDataUsage (extensible)
criteria		1..1	Expression	Expression describing additional data to be reported
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Measure.status	required	PublicationStatus
Measure.jurisdiction	extensible	Jurisdiction ValueSet
Measure.relatedArtifact:component.type	required	Fixed Value: composed-of
Measure.compositeScoring	extensible	CompositeMeasureScoring
Measure.type	extensible	MeasureType
Measure.group.population.code	extensible	MeasurePopulationType
Measure.supplementalData.code	extensible	MeasureDataUsage

Constraints

Id	Grade	Path(s)	Details	Requirements
cqm-2	warning	Measure.library	Measures utilizing CQL SHALL reference one and only one CQL library (and that referenced library MUST be the primary library for the measure) : exists()
cqm-3	warning	Measure.group.id	Group identifiers SHOULD use the convention: "group-[group number]", where [group number] corresponds with the group naming convention for the criteria within the group : value.startsWith('group-')
cqm-4	warning	Measure.group.population.criteria	Group population criteria SHOULD be simple expression names found within the primary library for the measure. The criteria SHOULD NOT include a namespace. : expression.contains('.').not()
cqm-5	warning	Measure.group.stratifier.criteria	Group stratifier criteria SHOULD be simple expression names found within the primary library for the measure. The criteria SHOULD NOT include a namespace. : expression.contains('.').not()
cqm-6	warning	Measure.supplementalData	Supplemental data SHALL use either criteria or path : criteria.exists() or path.exists()
dom-2	error	Measure	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Measure	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Measure	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Measure	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Measure	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mea-0	warning	Measure	Name should be usable as an identifier for the module by machine processing applications such as code generation : name.matches('[A-Z]([A-Za-z0-9_]){0,254}')
mea-1	error	Measure	Stratifier SHALL be either a single criteria or a set of criteria components : group.stratifier.all((code | description | criteria).exists() xor component.exists())

Name	Flags	Card.	Type	Description & Constraints
Measure	C	1..1	CQFMMeasure	A quality measure definition
id	Σ	0..1	id	Logical id of this artifact
meta	SΣ	1..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	SΣ	1..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
comment	S	0..*	(Complex)	Additional documentation, review, or usage guidance URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-artifactComment
allocation	S	0..1	markdown	Allocation guidance URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-allocation
softwaresystem	S	0..*	Reference(CQFM Device)	Extension URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem
scoringUnit	S	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
url	Σ	1..1	uri	Canonical identifier for this measure, represented as a URI (globally unique)
identifier	SΣ	0..*	Identifier	Additional identifier for the measure
version	Σ	1..1	string	Business version of the measure
name	ΣC	1..1	string	Name for this measure (computer friendly)
title	SΣ	0..1	string	Name for this measure (human friendly)
subtitle		0..1	string	Subordinate title of the measure
status	?!Σ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
experimental	Σ	1..1	boolean	For testing purposes, not real usage
subject[x]		0..1		E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: SubjectType (extensible): The possible types of subjects for a measure (E.g. Patient, Practitioner, Organization, Location, etc.).
subjectCodeableConcept			CodeableConcept
subjectReference			Reference(Group)
date	SΣ	0..1	dateTime	Date last changed
publisher	Σ	1..1	string	Name of the publisher (organization or individual)
contact	SΣ	0..*	ContactDetail	Contact details for the publisher
description	Σ	1..1	markdown	Natural language description of the measure
useContext	SΣ	0..*	UsageContext	The context that the content is intended to support
jurisdiction	SΣ	0..*	CodeableConcept	Intended jurisdiction for measure (if applicable) Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.
purpose		0..1	markdown	Why this measure is defined
usage		0..1	string	Describes the clinical usage of the measure
copyright		0..1	markdown	Use and/or publishing restrictions
approvalDate		0..1	date	When the measure was approved by publisher
lastReviewDate		0..1	date	When the measure was last reviewed
effectivePeriod	Σ	0..1	Period	When the measure is expected to be used
topic		0..*	CodeableConcept	The category of the measure, such as Education, Treatment, Assessment, etc. Binding: DefinitionTopic (example): High-level categorization of the definition, used for searching, sorting, and filtering.
author		0..*	ContactDetail	Who authored the content
editor		0..*	ContactDetail	Who edited the content
reviewer		0..*	ContactDetail	Who reviewed the content
endorser		0..*	ContactDetail	Who endorsed the content
Slices for relatedArtifact	S	0..*	RelatedArtifact	Additional documentation, citations, etc. Slice: Unordered, Open by value:type
relatedArtifact:component	S	0..*	RelatedArtifact	Additional documentation, citations, etc.
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
groupId	S	0..1	string	What group URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-groupId
weight	S	0..1	decimal	Contribution? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight
type	SΣ	1..1	code	Component measure Binding: RelatedArtifactType (required): The type of relationship to the related artifact. Fixed Value: composed-of
label	Σ	0..1	string	Short label
display	SΣ	0..1	string	Brief description of the related artifact
citation	Σ	0..1	markdown	Bibliographic citation for the artifact
url	Σ	0..1	url	Where the artifact can be accessed
document	Σ	0..1	Attachment	What document is being referenced
resource	SΣ	1..1	canonical(Measure)	What resource is being referenced
library	SC	0..1	canonical(CQFM Library)	CQFMMeasures are not required to use a Library, but if they do, it SHALL be a CQFMLibrary.
disclaimer	Σ	0..1	markdown	Disclaimer for use of the measure or its referenced content
scoring	Σ	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort Binding: MeasureScoring (extensible): The scoring type of the measure.
compositeScoring	SΣ	0..1	CodeableConcept	opportunity | all-or-nothing | linear | weighted Binding: CompositeMeasureScoring (extensible)
type	SΣ	0..*	CodeableConcept	process | outcome | structure | patient-reported-outcome | composite Binding: MeasureType (extensible)
riskAdjustment	Σ	0..1	string	How risk adjustment is applied for this measure
rateAggregation	Σ	0..1	string	How is rate aggregation performed for this measure
rationale	Σ	0..1	markdown	Detailed description of why the measure exists
clinicalRecommendationStatement	Σ	0..1	markdown	Summary of clinical guidelines
improvementNotation	Σ	0..1	CodeableConcept	increase | decrease Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.
definition	Σ	0..*	markdown	Defined terms used in the measure documentation
guidance	Σ	0..1	markdown	Additional guidance for implementers
group	S	0..*	BackboneElement	Population criteria group
id	SC	0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
compositeScoring	S	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
scoringUnit	S	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
component	S	0..*	RelatedArtifact	What artifact URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
groupId	S	0..1	string	What group URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-groupId
weight	S	0..1	decimal	Contribution? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight
url		1..1	uri	"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component"
value[x]		0..1	RelatedArtifact	Value of extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		0..1	CodeableConcept	Meaning of the group
description		0..1	string	Summary description
population	S	0..*	BackboneElement	Population criteria
id	S	1..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible)
description		0..1	string	The human readable description of this population criteria
criteria	SC	1..1	Expression	The criteria that defines this population
stratifier	S	0..*	BackboneElement	Stratifier criteria for the measure
id	S	1..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		0..1	CodeableConcept	Meaning of the stratifier
description		0..1	string	The human readable description of this stratifier
criteria	SC	0..1	Expression	How the measure should be stratified
component		0..*	BackboneElement	Stratifier criteria component for the measure
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		0..1	CodeableConcept	Meaning of the stratifier component
description		0..1	string	The human readable description of this stratifier component
criteria		1..1	Expression	Component of how the measure should be stratified
supplementalData	SC	0..*	BackboneElement	What other data should be reported with the measure
id	S	1..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the supplemental data Binding: MeasureDataUsage (extensible)
usage		0..*	CodeableConcept	supplemental-data | risk-adjustment-factor Binding: MeasureDataUsage (extensible): The intended usage for supplemental data elements in the measure.
description		0..1	string	The human readable description of this supplemental data
criteria		1..1	Expression	Expression describing additional data to be reported
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Measure.meta.security	extensible	All Security Labels
Measure.meta.tag	example	CommonTags
Measure.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Measure.status	required	PublicationStatus
Measure.subject[x]	extensible	SubjectType
Measure.jurisdiction	extensible	Jurisdiction ValueSet
Measure.topic	example	DefinitionTopic
Measure.relatedArtifact:component.type	required	Fixed Value: composed-of
Measure.scoring	extensible	MeasureScoring
Measure.compositeScoring	extensible	CompositeMeasureScoring
Measure.type	extensible	MeasureType
Measure.improvementNotation	required	MeasureImprovementNotation
Measure.group.population.code	extensible	MeasurePopulationType
Measure.supplementalData.code	extensible	MeasureDataUsage
Measure.supplementalData.usage	extensible	MeasureDataUsage

Constraints

Id	Grade	Path(s)	Details	Requirements
cqm-2	warning	Measure.library	Measures utilizing CQL SHALL reference one and only one CQL library (and that referenced library MUST be the primary library for the measure) : exists()
cqm-3	warning	Measure.group.id	Group identifiers SHOULD use the convention: "group-[group number]", where [group number] corresponds with the group naming convention for the criteria within the group : value.startsWith('group-')
cqm-4	warning	Measure.group.population.criteria	Group population criteria SHOULD be simple expression names found within the primary library for the measure. The criteria SHOULD NOT include a namespace. : expression.contains('.').not()
cqm-5	warning	Measure.group.stratifier.criteria	Group stratifier criteria SHOULD be simple expression names found within the primary library for the measure. The criteria SHOULD NOT include a namespace. : expression.contains('.').not()
cqm-6	warning	Measure.supplementalData	Supplemental data SHALL use either criteria or path : criteria.exists() or path.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Summary

Mandatory: 0 element (2 nested mandatory elements)
Must-Support: 15 elements
Fixed Value: 1 element

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
• http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-groupId
• http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight
• http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-compositeScoring
• http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component

Slices

This structure defines the following Slices:

• The element Measure.relatedArtifact is sliced based on the value of value:type

Name	Flags	Card.	Type	Description & Constraints
Measure		1..1	CQFMMeasure	A quality measure definition
scoringUnit	S	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
Slices for relatedArtifact	S	0..*	RelatedArtifact	Additional documentation, citations, etc. Slice: Unordered, Open by value:type
relatedArtifact:component	S	0..*	RelatedArtifact	Additional documentation, citations, etc.
groupId	S	0..1	string	What group URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-groupId
weight	S	0..1	decimal	Contribution? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight
type	S	1..1	code	Component measure Fixed Value: composed-of
display	S	0..1	string	Brief description of the related artifact
resource	S	1..1	canonical(Measure)	What resource is being referenced
compositeScoring	S	0..1	CodeableConcept	opportunity | all-or-nothing | linear | weighted Binding: CompositeMeasureScoring (extensible)
group	S	0..*	BackboneElement	Population criteria group
compositeScoring	S	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
scoringUnit	S	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
component	S	0..*	RelatedArtifact	What artifact URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component
groupId	S	0..1	string	What group URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-groupId
weight	S	0..1	decimal	Contribution? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Measure.compositeScoring	extensible	CompositeMeasureScoring

Name	Flags	Card.	Type	Description & Constraints
Measure	C	1..1	CQFMMeasure	A quality measure definition
meta	SΣ	1..1	Meta	Metadata about the resource
profile	SΣ	1..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
comment	S	0..*	(Complex)	Additional documentation, review, or usage guidance URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-artifactComment
allocation	S	0..1	markdown	Allocation guidance URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-allocation
softwaresystem	S	0..*	Reference(CQFM Device)	Extension URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem
scoringUnit	S	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
url	Σ	1..1	uri	Canonical identifier for this measure, represented as a URI (globally unique)
identifier	SΣ	0..*	Identifier	Additional identifier for the measure
version	Σ	1..1	string	Business version of the measure
name	ΣC	1..1	string	Name for this measure (computer friendly)
title	SΣ	0..1	string	Name for this measure (human friendly)
status	?!Σ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
experimental	Σ	1..1	boolean	For testing purposes, not real usage
date	SΣ	0..1	dateTime	Date last changed
publisher	Σ	1..1	string	Name of the publisher (organization or individual)
contact	SΣ	0..*	ContactDetail	Contact details for the publisher
description	Σ	1..1	markdown	Natural language description of the measure
useContext	SΣ	0..*	UsageContext	The context that the content is intended to support
jurisdiction	SΣ	0..*	CodeableConcept	Intended jurisdiction for measure (if applicable) Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.
Slices for relatedArtifact	S	0..*	RelatedArtifact	Additional documentation, citations, etc. Slice: Unordered, Open by value:type
relatedArtifact:component	S	0..*	RelatedArtifact	Additional documentation, citations, etc.
groupId	S	0..1	string	What group URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-groupId
weight	S	0..1	decimal	Contribution? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight
type	SΣ	1..1	code	Component measure Binding: RelatedArtifactType (required): The type of relationship to the related artifact. Fixed Value: composed-of
display	SΣ	0..1	string	Brief description of the related artifact
resource	SΣ	1..1	canonical(Measure)	What resource is being referenced
library	SC	0..1	canonical(CQFM Library)	CQFMMeasures are not required to use a Library, but if they do, it SHALL be a CQFMLibrary.
compositeScoring	SΣ	0..1	CodeableConcept	opportunity | all-or-nothing | linear | weighted Binding: CompositeMeasureScoring (extensible)
type	SΣ	0..*	CodeableConcept	process | outcome | structure | patient-reported-outcome | composite Binding: MeasureType (extensible)
group	S	0..*	BackboneElement	Population criteria group
id	SC	0..1	string	Unique id for inter-element referencing
compositeScoring	S	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
scoringUnit	S	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
component	S	0..*	RelatedArtifact	What artifact URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component
groupId	S	0..1	string	What group URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-groupId
weight	S	0..1	decimal	Contribution? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight
url		1..1	uri	"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component"
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
population	S	0..*	BackboneElement	Population criteria
id	S	1..1	string	Unique id for inter-element referencing
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible)
criteria	SC	1..1	Expression	The criteria that defines this population
stratifier	S	0..*	BackboneElement	Stratifier criteria for the measure
id	S	1..1	string	Unique id for inter-element referencing
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
criteria	SC	0..1	Expression	How the measure should be stratified
supplementalData	SC	0..*	BackboneElement	What other data should be reported with the measure
id	S	1..1	string	Unique id for inter-element referencing
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the supplemental data Binding: MeasureDataUsage (extensible)
criteria		1..1	Expression	Expression describing additional data to be reported
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Measure.status	required	PublicationStatus
Measure.jurisdiction	extensible	Jurisdiction ValueSet
Measure.relatedArtifact:component.type	required	Fixed Value: composed-of
Measure.compositeScoring	extensible	CompositeMeasureScoring
Measure.type	extensible	MeasureType
Measure.group.population.code	extensible	MeasurePopulationType
Measure.supplementalData.code	extensible	MeasureDataUsage

Constraints

Id	Grade	Path(s)	Details	Requirements
cqm-2	warning	Measure.library	Measures utilizing CQL SHALL reference one and only one CQL library (and that referenced library MUST be the primary library for the measure) : exists()
cqm-3	warning	Measure.group.id	Group identifiers SHOULD use the convention: "group-[group number]", where [group number] corresponds with the group naming convention for the criteria within the group : value.startsWith('group-')
cqm-4	warning	Measure.group.population.criteria	Group population criteria SHOULD be simple expression names found within the primary library for the measure. The criteria SHOULD NOT include a namespace. : expression.contains('.').not()
cqm-5	warning	Measure.group.stratifier.criteria	Group stratifier criteria SHOULD be simple expression names found within the primary library for the measure. The criteria SHOULD NOT include a namespace. : expression.contains('.').not()
cqm-6	warning	Measure.supplementalData	Supplemental data SHALL use either criteria or path : criteria.exists() or path.exists()
dom-2	error	Measure	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Measure	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Measure	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Measure	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Measure	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mea-0	warning	Measure	Name should be usable as an identifier for the module by machine processing applications such as code generation : name.matches('[A-Z]([A-Za-z0-9_]){0,254}')
mea-1	error	Measure	Stratifier SHALL be either a single criteria or a set of criteria components : group.stratifier.all((code | description | criteria).exists() xor component.exists())

Name	Flags	Card.	Type	Description & Constraints
Measure	C	1..1	CQFMMeasure	A quality measure definition
id	Σ	0..1	id	Logical id of this artifact
meta	SΣ	1..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	SΣ	1..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
comment	S	0..*	(Complex)	Additional documentation, review, or usage guidance URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-artifactComment
allocation	S	0..1	markdown	Allocation guidance URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-allocation
softwaresystem	S	0..*	Reference(CQFM Device)	Extension URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem
scoringUnit	S	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
url	Σ	1..1	uri	Canonical identifier for this measure, represented as a URI (globally unique)
identifier	SΣ	0..*	Identifier	Additional identifier for the measure
version	Σ	1..1	string	Business version of the measure
name	ΣC	1..1	string	Name for this measure (computer friendly)
title	SΣ	0..1	string	Name for this measure (human friendly)
subtitle		0..1	string	Subordinate title of the measure
status	?!Σ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
experimental	Σ	1..1	boolean	For testing purposes, not real usage
subject[x]		0..1		E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: SubjectType (extensible): The possible types of subjects for a measure (E.g. Patient, Practitioner, Organization, Location, etc.).
subjectCodeableConcept			CodeableConcept
subjectReference			Reference(Group)
date	SΣ	0..1	dateTime	Date last changed
publisher	Σ	1..1	string	Name of the publisher (organization or individual)
contact	SΣ	0..*	ContactDetail	Contact details for the publisher
description	Σ	1..1	markdown	Natural language description of the measure
useContext	SΣ	0..*	UsageContext	The context that the content is intended to support
jurisdiction	SΣ	0..*	CodeableConcept	Intended jurisdiction for measure (if applicable) Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.
purpose		0..1	markdown	Why this measure is defined
usage		0..1	string	Describes the clinical usage of the measure
copyright		0..1	markdown	Use and/or publishing restrictions
approvalDate		0..1	date	When the measure was approved by publisher
lastReviewDate		0..1	date	When the measure was last reviewed
effectivePeriod	Σ	0..1	Period	When the measure is expected to be used
topic		0..*	CodeableConcept	The category of the measure, such as Education, Treatment, Assessment, etc. Binding: DefinitionTopic (example): High-level categorization of the definition, used for searching, sorting, and filtering.
author		0..*	ContactDetail	Who authored the content
editor		0..*	ContactDetail	Who edited the content
reviewer		0..*	ContactDetail	Who reviewed the content
endorser		0..*	ContactDetail	Who endorsed the content
Slices for relatedArtifact	S	0..*	RelatedArtifact	Additional documentation, citations, etc. Slice: Unordered, Open by value:type
relatedArtifact:component	S	0..*	RelatedArtifact	Additional documentation, citations, etc.
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
groupId	S	0..1	string	What group URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-groupId
weight	S	0..1	decimal	Contribution? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight
type	SΣ	1..1	code	Component measure Binding: RelatedArtifactType (required): The type of relationship to the related artifact. Fixed Value: composed-of
label	Σ	0..1	string	Short label
display	SΣ	0..1	string	Brief description of the related artifact
citation	Σ	0..1	markdown	Bibliographic citation for the artifact
url	Σ	0..1	url	Where the artifact can be accessed
document	Σ	0..1	Attachment	What document is being referenced
resource	SΣ	1..1	canonical(Measure)	What resource is being referenced
library	SC	0..1	canonical(CQFM Library)	CQFMMeasures are not required to use a Library, but if they do, it SHALL be a CQFMLibrary.
disclaimer	Σ	0..1	markdown	Disclaimer for use of the measure or its referenced content
scoring	Σ	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort Binding: MeasureScoring (extensible): The scoring type of the measure.
compositeScoring	SΣ	0..1	CodeableConcept	opportunity | all-or-nothing | linear | weighted Binding: CompositeMeasureScoring (extensible)
type	SΣ	0..*	CodeableConcept	process | outcome | structure | patient-reported-outcome | composite Binding: MeasureType (extensible)
riskAdjustment	Σ	0..1	string	How risk adjustment is applied for this measure
rateAggregation	Σ	0..1	string	How is rate aggregation performed for this measure
rationale	Σ	0..1	markdown	Detailed description of why the measure exists
clinicalRecommendationStatement	Σ	0..1	markdown	Summary of clinical guidelines
improvementNotation	Σ	0..1	CodeableConcept	increase | decrease Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.
definition	Σ	0..*	markdown	Defined terms used in the measure documentation
guidance	Σ	0..1	markdown	Additional guidance for implementers
group	S	0..*	BackboneElement	Population criteria group
id	SC	0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
compositeScoring	S	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
scoringUnit	S	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
component	S	0..*	RelatedArtifact	What artifact URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
groupId	S	0..1	string	What group URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-groupId
weight	S	0..1	decimal	Contribution? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight
url		1..1	uri	"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component"
value[x]		0..1	RelatedArtifact	Value of extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		0..1	CodeableConcept	Meaning of the group
description		0..1	string	Summary description
population	S	0..*	BackboneElement	Population criteria
id	S	1..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible)
description		0..1	string	The human readable description of this population criteria
criteria	SC	1..1	Expression	The criteria that defines this population
stratifier	S	0..*	BackboneElement	Stratifier criteria for the measure
id	S	1..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		0..1	CodeableConcept	Meaning of the stratifier
description		0..1	string	The human readable description of this stratifier
criteria	SC	0..1	Expression	How the measure should be stratified
component		0..*	BackboneElement	Stratifier criteria component for the measure
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		0..1	CodeableConcept	Meaning of the stratifier component
description		0..1	string	The human readable description of this stratifier component
criteria		1..1	Expression	Component of how the measure should be stratified
supplementalData	SC	0..*	BackboneElement	What other data should be reported with the measure
id	S	1..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the supplemental data Binding: MeasureDataUsage (extensible)
usage		0..*	CodeableConcept	supplemental-data | risk-adjustment-factor Binding: MeasureDataUsage (extensible): The intended usage for supplemental data elements in the measure.
description		0..1	string	The human readable description of this supplemental data
criteria		1..1	Expression	Expression describing additional data to be reported
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Measure.meta.security	extensible	All Security Labels
Measure.meta.tag	example	CommonTags
Measure.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Measure.status	required	PublicationStatus
Measure.subject[x]	extensible	SubjectType
Measure.jurisdiction	extensible	Jurisdiction ValueSet
Measure.topic	example	DefinitionTopic
Measure.relatedArtifact:component.type	required	Fixed Value: composed-of
Measure.scoring	extensible	MeasureScoring
Measure.compositeScoring	extensible	CompositeMeasureScoring
Measure.type	extensible	MeasureType
Measure.improvementNotation	required	MeasureImprovementNotation
Measure.group.population.code	extensible	MeasurePopulationType
Measure.supplementalData.code	extensible	MeasureDataUsage
Measure.supplementalData.usage	extensible	MeasureDataUsage

Constraints

Id	Grade	Path(s)	Details	Requirements
cqm-2	warning	Measure.library	Measures utilizing CQL SHALL reference one and only one CQL library (and that referenced library MUST be the primary library for the measure) : exists()
cqm-3	warning	Measure.group.id	Group identifiers SHOULD use the convention: "group-[group number]", where [group number] corresponds with the group naming convention for the criteria within the group : value.startsWith('group-')
cqm-4	warning	Measure.group.population.criteria	Group population criteria SHOULD be simple expression names found within the primary library for the measure. The criteria SHOULD NOT include a namespace. : expression.contains('.').not()
cqm-5	warning	Measure.group.stratifier.criteria	Group stratifier criteria SHOULD be simple expression names found within the primary library for the measure. The criteria SHOULD NOT include a namespace. : expression.contains('.').not()
cqm-6	warning	Measure.supplementalData	Supplemental data SHALL use either criteria or path : criteria.exists() or path.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Summary

Mandatory: 0 element (2 nested mandatory elements)
Must-Support: 15 elements
Fixed Value: 1 element

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
• http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-groupId
• http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-weight
• http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-compositeScoring
• http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component

Slices

This structure defines the following Slices:

• The element Measure.relatedArtifact is sliced based on the value of value:type