This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v5.0.0: STU5 (v5.0.0)) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

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Resource Profile: CQFM Composite Measure

The CQFM Composite Measure Profile describes minimum expectations for a composite electronic Quality Measure (QM). For more information on the usage of this profile, refer to the Profiles and Packaging pages in this implementation guide.

Usage:

• Examples for this Resource Profile: PreventiveCareandWellnessAllOrNothingComposite, PreventiveCareandWellnessOpportunityComposite, PreventiveCareandWellnessPatientLevelLinearComposite and PreventiveCareandWellnessWeightedComposite

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from CQFMComputableMeasure

Name	Flags	Card.	Type	Description & Constraints
Measure		0..*	CQFMComputableMeasure	A quality measure definition
Slices for extension				Content/Rules for all slices
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.
Slices for extension				Content/Rules for all slices
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
scoring	S	0..1	CodeableConcept	composite Binding: Measure Scoring (extensible) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
code		1..1	code	Symbol in syntax defined by the system Fixed Value: composite
compositeScoring	S	0..1	CodeableConcept	opportunity | all-or-nothing | linear | weighted Binding: CompositeMeasureScoring (extensible)
group	SC	0..*	BackboneElement	Population criteria group cmp-10: Composite measures may not specify population criteria cmp-11: Composite measures must specify composite scoring and at least one component
Slices for extension				Content/Rules for all slices
scoring	SC	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring Binding: Measure Scoring (extensible): How the measure calculation is performed
scoringUnit	S	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
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
component	SC	0..*	(Complex)	What artifact URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component
Slices for extension				Content/Rules for all slices
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
population	SC	0..*	BackboneElement	Population criteria
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet / Code	URI
Measure.scoring	extensible	Pattern: composite http://terminology.hl7.org/ValueSet/measure-scoring
Measure.compositeScoring	extensible	CompositeMeasureScoring http://terminology.hl7.org/ValueSet/composite-measure-scoring

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-10	error	Measure.group	Composite measures may not specify population criteria : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code contains 'composite' implies population.count() = 0
cmp-11	error	Measure.group	Composite measures must specify composite scoring and at least one component : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code contains 'composite' implies extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-compositeScoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component').exists()

Name	Flags	Card.	Type	Description & Constraints
Measure	SC	0..*	CQFMComputableMeasure	A quality measure definition mea-0: Name should be usable as an identifier for the module by machine processing applications such as code generation mea-1: Stratifier SHALL be either a single criteria or a set of criteria components cmp-1: Population basis must be specified at the root, or on each group cmp-2: Scoring must either be specified at the root, or on each group cmp-3: Scoring unit may only be specified at the root if the scoring is also specified at the root cmp-4: Improvement notation must be specified for scoring types other than cohort cmp-5: If type is specified at the root, it may not be specified on any group cmp-6: If riskAdjustment is specified at the root, it may not be specified on any group cmp-7: If rateAggregation is specified at the root, it may not be specified on any group
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
populationBasis	SC	0..1	code	What type of population URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
effectiveDataRequirements	S	0..1	canonical(CRMI Module Definition Library)	Effective required data for evaluation URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringPrecision
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
subject[x]	S	0..1		E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: Subject Type Value Set (extensible)
subjectCodeableConcept			CodeableConcept
subjectReference			Reference(Group)
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.
Slices for extension				Content/Rules for all slices
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	S	0..1	canonical(CRMI Computable Library)	Logic used by the measure
scoring	SΣC	0..1	CodeableConcept	composite Binding: Measure Scoring (extensible) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
code		1..1	code	Symbol in syntax defined by the system Fixed Value: composite
compositeScoring	SΣ	0..1	CodeableConcept	opportunity | all-or-nothing | linear | weighted Binding: CompositeMeasureScoring (extensible)
type	SΣC	0..*	CodeableConcept	process | outcome | structure | patient-reported-outcome | composite Binding: MeasureType (extensible): The type of measure (includes codes from 2.16.840.1.113883.1.11.20368).
improvementNotation	SΣC	0..1	CodeableConcept	increase | decrease Binding: MeasureImprovementNotation (required)
group	SC	0..*	BackboneElement	Population criteria group cmp-8: Scoring unit may only be specified at the root if the scoring is also specified at the root cmp-9: Improvement notation must be specified for scoring types other than cohort cmp-10: Composite measures may not specify population criteria cmp-11: Composite measures must specify composite scoring and at least one component
Slices for extension				Content/Rules for all slices
populationBasis	SC	0..1	code	What type of population URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
scoring	SC	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring Binding: Measure Scoring (extensible): How the measure calculation is performed
scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringPrecision
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
component	SC	0..*	(Complex)	What artifact URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component
Slices for extension				Content/Rules for all slices
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"
type	C	0..*	CodeableConcept	process | outcome | structure | patient-reported-outcome URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type Binding: MeasureType (extensible): 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.
riskAdjustment	C	0..1	string	How risk adjustment is applied for this measure URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-riskAdjustment
rateAggregation	C	0..1	string	How is rate aggregation performed for this measure URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation
improvementNotation	SC	0..1	CodeableConcept	increase | decrease URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the group
description	S	0..1	string	Summary description
population	SC	0..*	BackboneElement	Population criteria
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population.
description	S	0..1	string	The human readable description of this population criteria
criteria		1..1	Expression	The criteria that defines this population
stratifier	S	0..*	BackboneElement	Stratifier criteria for the measure
Slices for extension				Content/Rules for all slices
appliesTo		0..*	CodeableConcept	Which population does this stratifier apply to? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo Binding: MeasurePopulationType (extensible): Indicates the population
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the stratifier
description	S	0..1	string	The human readable description of this stratifier
component	S	0..*	BackboneElement	Stratifier criteria component for the measure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the stratifier component
description	S	0..1	string	The human readable description of this stratifier component
criteria		1..1	Expression	Component of how the measure should be stratified
supplementalData	S	0..*	BackboneElement	What other data should be reported with the measure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the supplemental data
usage	S	0..*	CodeableConcept	supplemental-data | risk-adjustment-factor Binding: MeasureDataUsage (extensible): The intended usage for supplemental data elements in the measure.
description	S	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	URI
Measure.status	required	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 from the FHIR Standard
Measure.subject[x]	extensible	SubjectTypeValueSet http://hl7.org/fhir/us/cqfmeasures/ValueSet/subject-type from this IG
Measure.relatedArtifact:component.type	required	Fixed Value: composed-of http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1 from the FHIR Standard
Measure.scoring	extensible	Pattern: composite http://terminology.hl7.org/ValueSet/measure-scoring
Measure.compositeScoring	extensible	CompositeMeasureScoring http://terminology.hl7.org/ValueSet/composite-measure-scoring
Measure.type	extensible	MeasureType http://hl7.org/fhir/ValueSet/measure-type from the FHIR Standard
Measure.improvementNotation	required	MeasureImprovementNotation http://terminology.hl7.org/ValueSet/measure-improvement-notation
Measure.group.population.code	extensible	MeasurePopulationType http://hl7.org/fhir/ValueSet/measure-population from the FHIR Standard
Measure.supplementalData.usage	extensible	MeasureDataUsage http://hl7.org/fhir/ValueSet/measure-data-usage from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Measure	Population basis must be specified at the root, or on each group : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis').exists() or group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis').exists()).allTrue()
cmp-2	error	Measure	Scoring must either be specified at the root, or on each group : scoring.exists() xor (group.exists() and group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists()).allTrue())
cmp-3	error	Measure	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit').exists() implies scoring.exists()
cmp-4	error	Measure	Improvement notation must be specified for scoring types other than cohort : (scoring.exists() and (scoring.coding.code.contains('proportion') or scoring.coding.code.contains('ratio') or scoring.coding.code.contains('continuous-variable') or scoring.coding.code.contains('composite')) and improvementNotation.exists()) xor (group.exists() and group.select((extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and (extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('proportion') or extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('ratio') or extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('continuous-variable') or extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('composite')) and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation').exists())).allTrue()) xor (scoring.exists() and scoring.coding.code.contains('cohort'))
cmp-5	error	Measure	If type is specified at the root, it may not be specified on any group : type.exists() implies group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type').exists()).allFalse()
cmp-6	error	Measure	If riskAdjustment is specified at the root, it may not be specified on any group : riskAdjustment.exists() implies group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-riskAdjustment').exists()).allFalse()
cmp-7	error	Measure	If rateAggregation is specified at the root, it may not be specified on any group : rateAggregation.exists() implies group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation').exists()).allFalse()
cmp-8	error	Measure.group	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit').exists() implies extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists()
cmp-9	error	Measure.group	Improvement notation must be specified for scoring types other than cohort : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value in ('proportion' | 'ratio' | 'continuous-variable') implies extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation').exists()
cmp-10	error	Measure.group	Composite measures may not specify population criteria : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code contains 'composite' implies population.count() = 0
cmp-11	error	Measure.group	Composite measures must specify composite scoring and at least one component : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code contains 'composite' implies extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-compositeScoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component').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	SC	0..*	CQFMComputableMeasure	A quality measure definition mea-0: Name should be usable as an identifier for the module by machine processing applications such as code generation mea-1: Stratifier SHALL be either a single criteria or a set of criteria components cmp-1: Population basis must be specified at the root, or on each group cmp-2: Scoring must either be specified at the root, or on each group cmp-3: Scoring unit may only be specified at the root if the scoring is also specified at the root cmp-4: Improvement notation must be specified for scoring types other than cohort cmp-5: If type is specified at the root, it may not be specified on any group cmp-6: If riskAdjustment is specified at the root, it may not be specified on any group cmp-7: If rateAggregation is specified at the root, it may not be specified on any group
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
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
populationBasis	SC	0..1	code	What type of population URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
effectiveDataRequirements	S	0..1	canonical(CRMI Module Definition Library)	Effective required data for evaluation URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringPrecision
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
url	Σ	0..1	uri	Canonical identifier for this measure, represented as a URI (globally unique)
identifier	Σ	0..*	Identifier	Additional identifier for the measure
version	Σ	0..1	string	Business version of the measure
name	ΣC	0..1	string	Name for this measure (computer friendly)
title	Σ	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	0..1	boolean	For testing purposes, not real usage
subject[x]	S	0..1		E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: Subject Type Value Set (extensible)
subjectCodeableConcept			CodeableConcept
subjectReference			Reference(Group)
date	Σ	0..1	dateTime	Date last changed
publisher	Σ	0..1	string	Name of the publisher (organization or individual)
contact	Σ	0..*	ContactDetail	Contact details for the publisher
description	Σ	0..1	markdown	Natural language description of the measure
useContext	Σ	0..*	UsageContext	The context that the content is intended to support
jurisdiction	Σ	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	S	0..1	canonical(CRMI Computable Library)	Logic used by the measure
disclaimer	Σ	0..1	markdown	Disclaimer for use of the measure or its referenced content
scoring	SΣC	0..1	CodeableConcept	composite Binding: Measure Scoring (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: composite
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
compositeScoring	SΣ	0..1	CodeableConcept	opportunity | all-or-nothing | linear | weighted Binding: CompositeMeasureScoring (extensible)
type	SΣC	0..*	CodeableConcept	process | outcome | structure | patient-reported-outcome | composite Binding: MeasureType (extensible): The type of measure (includes codes from 2.16.840.1.113883.1.11.20368).
riskAdjustment	ΣC	0..1	string	How risk adjustment is applied for this measure
rateAggregation	ΣC	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	SΣC	0..1	CodeableConcept	increase | decrease Binding: MeasureImprovementNotation (required)
definition	Σ	0..*	markdown	Defined terms used in the measure documentation
guidance	Σ	0..1	markdown	Additional guidance for implementers
group	SC	0..*	BackboneElement	Population criteria group cmp-8: Scoring unit may only be specified at the root if the scoring is also specified at the root cmp-9: Improvement notation must be specified for scoring types other than cohort cmp-10: Composite measures may not specify population criteria cmp-11: Composite measures must specify composite scoring and at least one component
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
populationBasis	SC	0..1	code	What type of population URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
scoring	SC	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring Binding: Measure Scoring (extensible): How the measure calculation is performed
scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringPrecision
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
component	SC	0..*	(Complex)	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
type	C	0..*	CodeableConcept	process | outcome | structure | patient-reported-outcome URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type Binding: MeasureType (extensible): 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.
riskAdjustment	C	0..1	string	How risk adjustment is applied for this measure URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-riskAdjustment
rateAggregation	C	0..1	string	How is rate aggregation performed for this measure URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation
improvementNotation	SC	0..1	CodeableConcept	increase | decrease URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the group
description	S	0..1	string	Summary description
population	SC	0..*	BackboneElement	Population criteria
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	S	0..1	CodeableConcept	initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population.
description	S	0..1	string	The human readable description of this population criteria
criteria		1..1	Expression	The criteria that defines this population
stratifier	S	0..*	BackboneElement	Stratifier criteria for the measure
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
appliesTo		0..*	CodeableConcept	Which population does this stratifier apply to? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo Binding: MeasurePopulationType (extensible): Indicates the population
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the stratifier
description	S	0..1	string	The human readable description of this stratifier
criteria		0..1	Expression	How the measure should be stratified
component	S	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	S	0..1	CodeableConcept	Meaning of the stratifier component
description	S	0..1	string	The human readable description of this stratifier component
criteria		1..1	Expression	Component of how the measure should be stratified
supplementalData	S	0..*	BackboneElement	What other data should be reported with 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	S	0..1	CodeableConcept	Meaning of the supplemental data
usage	S	0..*	CodeableConcept	supplemental-data | risk-adjustment-factor Binding: MeasureDataUsage (extensible): The intended usage for supplemental data elements in the measure.
description	S	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	URI
Measure.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Measure.status	required	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 from the FHIR Standard
Measure.subject[x]	extensible	SubjectTypeValueSet http://hl7.org/fhir/us/cqfmeasures/ValueSet/subject-type from this IG
Measure.jurisdiction	extensible	Jurisdiction ValueSet http://hl7.org/fhir/ValueSet/jurisdiction from the FHIR Standard
Measure.topic	example	DefinitionTopic http://hl7.org/fhir/ValueSet/definition-topic from the FHIR Standard
Measure.relatedArtifact:component.type	required	Fixed Value: composed-of http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1 from the FHIR Standard
Measure.scoring	extensible	Pattern: composite http://terminology.hl7.org/ValueSet/measure-scoring
Measure.compositeScoring	extensible	CompositeMeasureScoring http://terminology.hl7.org/ValueSet/composite-measure-scoring
Measure.type	extensible	MeasureType http://hl7.org/fhir/ValueSet/measure-type from the FHIR Standard
Measure.improvementNotation	required	MeasureImprovementNotation http://terminology.hl7.org/ValueSet/measure-improvement-notation
Measure.group.population.code	extensible	MeasurePopulationType http://hl7.org/fhir/ValueSet/measure-population from the FHIR Standard
Measure.supplementalData.usage	extensible	MeasureDataUsage http://hl7.org/fhir/ValueSet/measure-data-usage from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Measure	Population basis must be specified at the root, or on each group : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis').exists() or group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis').exists()).allTrue()
cmp-2	error	Measure	Scoring must either be specified at the root, or on each group : scoring.exists() xor (group.exists() and group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists()).allTrue())
cmp-3	error	Measure	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit').exists() implies scoring.exists()
cmp-4	error	Measure	Improvement notation must be specified for scoring types other than cohort : (scoring.exists() and (scoring.coding.code.contains('proportion') or scoring.coding.code.contains('ratio') or scoring.coding.code.contains('continuous-variable') or scoring.coding.code.contains('composite')) and improvementNotation.exists()) xor (group.exists() and group.select((extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and (extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('proportion') or extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('ratio') or extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('continuous-variable') or extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('composite')) and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation').exists())).allTrue()) xor (scoring.exists() and scoring.coding.code.contains('cohort'))
cmp-5	error	Measure	If type is specified at the root, it may not be specified on any group : type.exists() implies group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type').exists()).allFalse()
cmp-6	error	Measure	If riskAdjustment is specified at the root, it may not be specified on any group : riskAdjustment.exists() implies group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-riskAdjustment').exists()).allFalse()
cmp-7	error	Measure	If rateAggregation is specified at the root, it may not be specified on any group : rateAggregation.exists() implies group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation').exists()).allFalse()
cmp-8	error	Measure.group	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit').exists() implies extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists()
cmp-9	error	Measure.group	Improvement notation must be specified for scoring types other than cohort : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value in ('proportion' | 'ratio' | 'continuous-variable') implies extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation').exists()
cmp-10	error	Measure.group	Composite measures may not specify population criteria : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code contains 'composite' implies population.count() = 0
cmp-11	error	Measure.group	Composite measures must specify composite scoring and at least one component : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code contains 'composite' implies extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-compositeScoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component').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())

This structure is derived from CQFMComputableMeasure

Summary

Mandatory: 0 element(2 nested mandatory elements)
Must-Support: 18 elements
Fixed: 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-scoring
• 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 1 is sliced based on the value of Measure.relatedArtifact

Differential View

This structure is derived from CQFMComputableMeasure

Name	Flags	Card.	Type	Description & Constraints
Measure		0..*	CQFMComputableMeasure	A quality measure definition
Slices for extension				Content/Rules for all slices
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.
Slices for extension				Content/Rules for all slices
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
scoring	S	0..1	CodeableConcept	composite Binding: Measure Scoring (extensible) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
code		1..1	code	Symbol in syntax defined by the system Fixed Value: composite
compositeScoring	S	0..1	CodeableConcept	opportunity | all-or-nothing | linear | weighted Binding: CompositeMeasureScoring (extensible)
group	SC	0..*	BackboneElement	Population criteria group cmp-10: Composite measures may not specify population criteria cmp-11: Composite measures must specify composite scoring and at least one component
Slices for extension				Content/Rules for all slices
scoring	SC	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring Binding: Measure Scoring (extensible): How the measure calculation is performed
scoringUnit	S	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
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
component	SC	0..*	(Complex)	What artifact URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component
Slices for extension				Content/Rules for all slices
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
population	SC	0..*	BackboneElement	Population criteria
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet / Code	URI
Measure.scoring	extensible	Pattern: composite http://terminology.hl7.org/ValueSet/measure-scoring
Measure.compositeScoring	extensible	CompositeMeasureScoring http://terminology.hl7.org/ValueSet/composite-measure-scoring

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-10	error	Measure.group	Composite measures may not specify population criteria : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code contains 'composite' implies population.count() = 0
cmp-11	error	Measure.group	Composite measures must specify composite scoring and at least one component : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code contains 'composite' implies extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-compositeScoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component').exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Measure	SC	0..*	CQFMComputableMeasure	A quality measure definition mea-0: Name should be usable as an identifier for the module by machine processing applications such as code generation mea-1: Stratifier SHALL be either a single criteria or a set of criteria components cmp-1: Population basis must be specified at the root, or on each group cmp-2: Scoring must either be specified at the root, or on each group cmp-3: Scoring unit may only be specified at the root if the scoring is also specified at the root cmp-4: Improvement notation must be specified for scoring types other than cohort cmp-5: If type is specified at the root, it may not be specified on any group cmp-6: If riskAdjustment is specified at the root, it may not be specified on any group cmp-7: If rateAggregation is specified at the root, it may not be specified on any group
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
populationBasis	SC	0..1	code	What type of population URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
effectiveDataRequirements	S	0..1	canonical(CRMI Module Definition Library)	Effective required data for evaluation URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringPrecision
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
subject[x]	S	0..1		E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: Subject Type Value Set (extensible)
subjectCodeableConcept			CodeableConcept
subjectReference			Reference(Group)
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.
Slices for extension				Content/Rules for all slices
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	S	0..1	canonical(CRMI Computable Library)	Logic used by the measure
scoring	SΣC	0..1	CodeableConcept	composite Binding: Measure Scoring (extensible) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
code		1..1	code	Symbol in syntax defined by the system Fixed Value: composite
compositeScoring	SΣ	0..1	CodeableConcept	opportunity | all-or-nothing | linear | weighted Binding: CompositeMeasureScoring (extensible)
type	SΣC	0..*	CodeableConcept	process | outcome | structure | patient-reported-outcome | composite Binding: MeasureType (extensible): The type of measure (includes codes from 2.16.840.1.113883.1.11.20368).
improvementNotation	SΣC	0..1	CodeableConcept	increase | decrease Binding: MeasureImprovementNotation (required)
group	SC	0..*	BackboneElement	Population criteria group cmp-8: Scoring unit may only be specified at the root if the scoring is also specified at the root cmp-9: Improvement notation must be specified for scoring types other than cohort cmp-10: Composite measures may not specify population criteria cmp-11: Composite measures must specify composite scoring and at least one component
Slices for extension				Content/Rules for all slices
populationBasis	SC	0..1	code	What type of population URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
scoring	SC	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring Binding: Measure Scoring (extensible): How the measure calculation is performed
scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringPrecision
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
component	SC	0..*	(Complex)	What artifact URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component
Slices for extension				Content/Rules for all slices
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"
type	C	0..*	CodeableConcept	process | outcome | structure | patient-reported-outcome URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type Binding: MeasureType (extensible): 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.
riskAdjustment	C	0..1	string	How risk adjustment is applied for this measure URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-riskAdjustment
rateAggregation	C	0..1	string	How is rate aggregation performed for this measure URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation
improvementNotation	SC	0..1	CodeableConcept	increase | decrease URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the group
description	S	0..1	string	Summary description
population	SC	0..*	BackboneElement	Population criteria
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population.
description	S	0..1	string	The human readable description of this population criteria
criteria		1..1	Expression	The criteria that defines this population
stratifier	S	0..*	BackboneElement	Stratifier criteria for the measure
Slices for extension				Content/Rules for all slices
appliesTo		0..*	CodeableConcept	Which population does this stratifier apply to? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo Binding: MeasurePopulationType (extensible): Indicates the population
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the stratifier
description	S	0..1	string	The human readable description of this stratifier
component	S	0..*	BackboneElement	Stratifier criteria component for the measure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the stratifier component
description	S	0..1	string	The human readable description of this stratifier component
criteria		1..1	Expression	Component of how the measure should be stratified
supplementalData	S	0..*	BackboneElement	What other data should be reported with the measure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the supplemental data
usage	S	0..*	CodeableConcept	supplemental-data | risk-adjustment-factor Binding: MeasureDataUsage (extensible): The intended usage for supplemental data elements in the measure.
description	S	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	URI
Measure.status	required	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 from the FHIR Standard
Measure.subject[x]	extensible	SubjectTypeValueSet http://hl7.org/fhir/us/cqfmeasures/ValueSet/subject-type from this IG
Measure.relatedArtifact:component.type	required	Fixed Value: composed-of http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1 from the FHIR Standard
Measure.scoring	extensible	Pattern: composite http://terminology.hl7.org/ValueSet/measure-scoring
Measure.compositeScoring	extensible	CompositeMeasureScoring http://terminology.hl7.org/ValueSet/composite-measure-scoring
Measure.type	extensible	MeasureType http://hl7.org/fhir/ValueSet/measure-type from the FHIR Standard
Measure.improvementNotation	required	MeasureImprovementNotation http://terminology.hl7.org/ValueSet/measure-improvement-notation
Measure.group.population.code	extensible	MeasurePopulationType http://hl7.org/fhir/ValueSet/measure-population from the FHIR Standard
Measure.supplementalData.usage	extensible	MeasureDataUsage http://hl7.org/fhir/ValueSet/measure-data-usage from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Measure	Population basis must be specified at the root, or on each group : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis').exists() or group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis').exists()).allTrue()
cmp-2	error	Measure	Scoring must either be specified at the root, or on each group : scoring.exists() xor (group.exists() and group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists()).allTrue())
cmp-3	error	Measure	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit').exists() implies scoring.exists()
cmp-4	error	Measure	Improvement notation must be specified for scoring types other than cohort : (scoring.exists() and (scoring.coding.code.contains('proportion') or scoring.coding.code.contains('ratio') or scoring.coding.code.contains('continuous-variable') or scoring.coding.code.contains('composite')) and improvementNotation.exists()) xor (group.exists() and group.select((extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and (extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('proportion') or extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('ratio') or extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('continuous-variable') or extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('composite')) and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation').exists())).allTrue()) xor (scoring.exists() and scoring.coding.code.contains('cohort'))
cmp-5	error	Measure	If type is specified at the root, it may not be specified on any group : type.exists() implies group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type').exists()).allFalse()
cmp-6	error	Measure	If riskAdjustment is specified at the root, it may not be specified on any group : riskAdjustment.exists() implies group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-riskAdjustment').exists()).allFalse()
cmp-7	error	Measure	If rateAggregation is specified at the root, it may not be specified on any group : rateAggregation.exists() implies group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation').exists()).allFalse()
cmp-8	error	Measure.group	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit').exists() implies extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists()
cmp-9	error	Measure.group	Improvement notation must be specified for scoring types other than cohort : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value in ('proportion' | 'ratio' | 'continuous-variable') implies extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation').exists()
cmp-10	error	Measure.group	Composite measures may not specify population criteria : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code contains 'composite' implies population.count() = 0
cmp-11	error	Measure.group	Composite measures must specify composite scoring and at least one component : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code contains 'composite' implies extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-compositeScoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component').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())

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Measure	SC	0..*	CQFMComputableMeasure	A quality measure definition mea-0: Name should be usable as an identifier for the module by machine processing applications such as code generation mea-1: Stratifier SHALL be either a single criteria or a set of criteria components cmp-1: Population basis must be specified at the root, or on each group cmp-2: Scoring must either be specified at the root, or on each group cmp-3: Scoring unit may only be specified at the root if the scoring is also specified at the root cmp-4: Improvement notation must be specified for scoring types other than cohort cmp-5: If type is specified at the root, it may not be specified on any group cmp-6: If riskAdjustment is specified at the root, it may not be specified on any group cmp-7: If rateAggregation is specified at the root, it may not be specified on any group
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
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
populationBasis	SC	0..1	code	What type of population URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
effectiveDataRequirements	S	0..1	canonical(CRMI Module Definition Library)	Effective required data for evaluation URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringPrecision
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
url	Σ	0..1	uri	Canonical identifier for this measure, represented as a URI (globally unique)
identifier	Σ	0..*	Identifier	Additional identifier for the measure
version	Σ	0..1	string	Business version of the measure
name	ΣC	0..1	string	Name for this measure (computer friendly)
title	Σ	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	0..1	boolean	For testing purposes, not real usage
subject[x]	S	0..1		E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: Subject Type Value Set (extensible)
subjectCodeableConcept			CodeableConcept
subjectReference			Reference(Group)
date	Σ	0..1	dateTime	Date last changed
publisher	Σ	0..1	string	Name of the publisher (organization or individual)
contact	Σ	0..*	ContactDetail	Contact details for the publisher
description	Σ	0..1	markdown	Natural language description of the measure
useContext	Σ	0..*	UsageContext	The context that the content is intended to support
jurisdiction	Σ	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	S	0..1	canonical(CRMI Computable Library)	Logic used by the measure
disclaimer	Σ	0..1	markdown	Disclaimer for use of the measure or its referenced content
scoring	SΣC	0..1	CodeableConcept	composite Binding: Measure Scoring (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: composite
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
compositeScoring	SΣ	0..1	CodeableConcept	opportunity | all-or-nothing | linear | weighted Binding: CompositeMeasureScoring (extensible)
type	SΣC	0..*	CodeableConcept	process | outcome | structure | patient-reported-outcome | composite Binding: MeasureType (extensible): The type of measure (includes codes from 2.16.840.1.113883.1.11.20368).
riskAdjustment	ΣC	0..1	string	How risk adjustment is applied for this measure
rateAggregation	ΣC	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	SΣC	0..1	CodeableConcept	increase | decrease Binding: MeasureImprovementNotation (required)
definition	Σ	0..*	markdown	Defined terms used in the measure documentation
guidance	Σ	0..1	markdown	Additional guidance for implementers
group	SC	0..*	BackboneElement	Population criteria group cmp-8: Scoring unit may only be specified at the root if the scoring is also specified at the root cmp-9: Improvement notation must be specified for scoring types other than cohort cmp-10: Composite measures may not specify population criteria cmp-11: Composite measures must specify composite scoring and at least one component
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
populationBasis	SC	0..1	code	What type of population URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
scoring	SC	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring Binding: Measure Scoring (extensible): How the measure calculation is performed
scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringPrecision
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
component	SC	0..*	(Complex)	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
type	C	0..*	CodeableConcept	process | outcome | structure | patient-reported-outcome URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type Binding: MeasureType (extensible): 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.
riskAdjustment	C	0..1	string	How risk adjustment is applied for this measure URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-riskAdjustment
rateAggregation	C	0..1	string	How is rate aggregation performed for this measure URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation
improvementNotation	SC	0..1	CodeableConcept	increase | decrease URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the group
description	S	0..1	string	Summary description
population	SC	0..*	BackboneElement	Population criteria
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	S	0..1	CodeableConcept	initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population.
description	S	0..1	string	The human readable description of this population criteria
criteria		1..1	Expression	The criteria that defines this population
stratifier	S	0..*	BackboneElement	Stratifier criteria for the measure
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
appliesTo		0..*	CodeableConcept	Which population does this stratifier apply to? URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo Binding: MeasurePopulationType (extensible): Indicates the population
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the stratifier
description	S	0..1	string	The human readable description of this stratifier
criteria		0..1	Expression	How the measure should be stratified
component	S	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	S	0..1	CodeableConcept	Meaning of the stratifier component
description	S	0..1	string	The human readable description of this stratifier component
criteria		1..1	Expression	Component of how the measure should be stratified
supplementalData	S	0..*	BackboneElement	What other data should be reported with 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	S	0..1	CodeableConcept	Meaning of the supplemental data
usage	S	0..*	CodeableConcept	supplemental-data | risk-adjustment-factor Binding: MeasureDataUsage (extensible): The intended usage for supplemental data elements in the measure.
description	S	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	URI
Measure.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Measure.status	required	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 from the FHIR Standard
Measure.subject[x]	extensible	SubjectTypeValueSet http://hl7.org/fhir/us/cqfmeasures/ValueSet/subject-type from this IG
Measure.jurisdiction	extensible	Jurisdiction ValueSet http://hl7.org/fhir/ValueSet/jurisdiction from the FHIR Standard
Measure.topic	example	DefinitionTopic http://hl7.org/fhir/ValueSet/definition-topic from the FHIR Standard
Measure.relatedArtifact:component.type	required	Fixed Value: composed-of http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1 from the FHIR Standard
Measure.scoring	extensible	Pattern: composite http://terminology.hl7.org/ValueSet/measure-scoring
Measure.compositeScoring	extensible	CompositeMeasureScoring http://terminology.hl7.org/ValueSet/composite-measure-scoring
Measure.type	extensible	MeasureType http://hl7.org/fhir/ValueSet/measure-type from the FHIR Standard
Measure.improvementNotation	required	MeasureImprovementNotation http://terminology.hl7.org/ValueSet/measure-improvement-notation
Measure.group.population.code	extensible	MeasurePopulationType http://hl7.org/fhir/ValueSet/measure-population from the FHIR Standard
Measure.supplementalData.usage	extensible	MeasureDataUsage http://hl7.org/fhir/ValueSet/measure-data-usage from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Measure	Population basis must be specified at the root, or on each group : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis').exists() or group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis').exists()).allTrue()
cmp-2	error	Measure	Scoring must either be specified at the root, or on each group : scoring.exists() xor (group.exists() and group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists()).allTrue())
cmp-3	error	Measure	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit').exists() implies scoring.exists()
cmp-4	error	Measure	Improvement notation must be specified for scoring types other than cohort : (scoring.exists() and (scoring.coding.code.contains('proportion') or scoring.coding.code.contains('ratio') or scoring.coding.code.contains('continuous-variable') or scoring.coding.code.contains('composite')) and improvementNotation.exists()) xor (group.exists() and group.select((extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and (extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('proportion') or extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('ratio') or extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('continuous-variable') or extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('composite')) and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation').exists())).allTrue()) xor (scoring.exists() and scoring.coding.code.contains('cohort'))
cmp-5	error	Measure	If type is specified at the root, it may not be specified on any group : type.exists() implies group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type').exists()).allFalse()
cmp-6	error	Measure	If riskAdjustment is specified at the root, it may not be specified on any group : riskAdjustment.exists() implies group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-riskAdjustment').exists()).allFalse()
cmp-7	error	Measure	If rateAggregation is specified at the root, it may not be specified on any group : rateAggregation.exists() implies group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation').exists()).allFalse()
cmp-8	error	Measure.group	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit').exists() implies extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists()
cmp-9	error	Measure.group	Improvement notation must be specified for scoring types other than cohort : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value in ('proportion' | 'ratio' | 'continuous-variable') implies extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation').exists()
cmp-10	error	Measure.group	Composite measures may not specify population criteria : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code contains 'composite' implies population.count() = 0
cmp-11	error	Measure.group	Composite measures must specify composite scoring and at least one component : extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code contains 'composite' implies extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-compositeScoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component').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())

This structure is derived from CQFMComputableMeasure

Summary

Mandatory: 0 element(2 nested mandatory elements)
Must-Support: 18 elements
Fixed: 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-scoring
• 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 1 is sliced based on the value of Measure.relatedArtifact