Data Exchange For Quality Measures STU3 for FHIR R4
2.1.0 - Ballot

This page is part of the Da Vinci Data Exchange for Quality Measures (DEQM) FHIR IG (v2.1.0: STU 3) based on FHIR R4. The current version which supercedes this version is 3.1.0. For a full list of available versions, see the Directory of published versions

Resource Profile: DEQMGapsInCareIndividualMeasureReportProfile

MeasureReport is used as an organizer for both data exchange for measure and for measure reporting. Four profiles on the MeasureReport resource are defined in this guide to delineate these different uses. The DEQM Gaps In Care Individual MeasureReport Profile defined here is based on the DEQM Individual MeasureReport Profile. It is used when a gaps in care report for a measure is reported to an aggregator for one specific patient. It contains all of the data that is relevant to generate the gaps in care report including the measure outcome and is similar to a QRDA Category 1 report. The DEQM Gaps In Care Individual MeasureReport Profile differs from a DEQM Individual MeasureReport Profile by specifying additionally that an evaluated resource can be associated with a specific population within a measure through the DEQM Population Reference Extension.

The official URL for this profile is:

http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-indv-measurereport-deqm

ONLY the new content for Gaps in Care is in the scope for ballot for the September, 2020 Ballot Cycle.

This profile builds on DEQM Individual MeasureReport Profile.

Mandatory Data Elements and Terminology

The following data-elements are mandatory (i.e data MUST be present).

Each must have:

  1. A status
  2. A measure report type hardcoded to “individual”
  3. The reference to the Measure
  4. A patient the gaps in care report is for
  5. The date the gaps in care report was generated
  6. The organization that reported the data
  7. The measurement period
  8. The results of the calculation (the Measure Score)
  1. The gaps through period (Note that in a gaps in care report, it uses the gaps through period instead of the measurement period.)

Each should have (Must Support):

  1. Measure results for each group
  2. The number of members for each population in a group
  3. Indicate whether improvement in the measure is noted by an increase or decrease in the measure score.
  4. References to other resources involved in producing the report
  5. The scoring type defined by the referenced Measure using the DEQM Measure Scoring Extension
  6. Reference to a reporting vendor using the DEQM Reporting Vendor Extension
  7. A certification identifier using the DEQM Certification Identifier Extension
  8. Ability to use other types for measure score using the DEQM Alternate Score Type Extension
  9. Specify the software systems used by the reporting system using the CQFM Software System Extension
  1. Specify population reference for each evaluatedResource using the DEQM Population Reference Extension

Additional Profile specific implementation guidance:

  • The MeasureReport.group.population.id is a must support element because it is used to link across the Measure and is equal to the Measure.population.group.id. This is needed because the MeasureReport.group.population.code is insufficient when the measure types have multiple populations with the same code.

  • If the measure scoring type is ‘proportion’, ‘ratio’, or ‘continuous-variable’ then the improvementNotation element is required.

  • The reporter should be consistent with the X-Provenance header data if present.

  • the DEQM Reporting Vendor Extension is intended to represent the submitting entity when it is not the same as the reporting entity.

Examples

Formal Views of Profile Content

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

This structure is derived from DEQMIndividualMeasureReportProfile

Summary

Must-Support: 1 element

Extensions

This structure refers to these extensions:

NameFlagsCard.TypeDescription & Constraintsdoco
.. MeasureReport I0..*DEQMIndividualMeasureReportProfileResults of a measure evaluation
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionExtension
Slice: Unordered, Open by value:url
... extension-measureScoring SI0..1CodeableConceptExtension
URL: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring
... extension-reportingVendor SI0..1Reference(DEQM Organization Profile)Vendor information
URL: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-reportingVendor
... extension-certificationIdentifier SI0..1IdentifierCMS EHR Certifciation ID
URL: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-certificationIdentifier
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... url 1..1uri"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-certificationIdentifier"
.... value[x] I1..1(Slice Definition)Value of extension
Slice: Unordered, Closed by type:$this
..... value[x]:valueIdentifier SI1..1IdentifierValue of extension
Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... use0..1codeusual | official | temp | secondary | old (If known)
...... type0..1CodeableConceptDescription of identifier
...... system1..1uriThe namespace for the identifier value
Fixed Value: urn:oid:2.16.840.1.113883.3.2074.1
...... value0..1stringThe value that is unique
...... period0..1PeriodTime period when id is/was valid for use
...... assigner0..1Reference(Organization)Organization that issued id (may be just text)
... cqfm-softwaresystem SI0..*Reference(CQFMDevice)Extension
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierAdditional identifier for the MeasureReport
... status ?!SΣI1..1codecomplete | pending | error
Binding: MeasureReportStatus (required)
... type SΣI1..1codeindividual | subject-list | summary | data-collection
Binding: MeasureReportType (required)
Fixed Value: individual
... measure SΣI1..1canonical(Measure)What measure was calculated
... subject SΣI1..1Reference(QICorePatient)What individual(s) the report is for
... date SΣI1..1dateTimeWhen the report was generated
... reporter SΣI1..1Reference(DEQM Organization Profile)The organization where the measure was completed
... period SΣI1..1PeriodWhat period the report covers
deqm-1: Date precision SHALL be at least to day ( YYYY-MM-DD )
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... start SΣI1..1dateTimeStarting time with inclusive boundary
.... end SΣI1..1dateTimeEnd time with inclusive boundary, if not ongoing
... improvementNotation ?!SΣI0..1CodeableConceptincrease | decrease
Binding: MeasureImprovementNotation (required)
... group SI0..*BackboneElementMeasure results for each group
.... id S0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code ΣI0..1CodeableConceptMeaning of the group
.... population SI1..*BackboneElementThe populations in the group
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣI1..1CodeableConceptinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible)
..... count SI0..1integerSize of the population
.... measureScore SΣI1..1QuantityWhat score this group achieved
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... extension-alternateScoreType SI0..1dateTime, CodeableConcept, Period, Range, DurationPossible additional measureScore value types
URL: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-alternateScoreType
..... value ΣI0..1decimalNumerical value (with implicit precision)
..... comparator ?!ΣI0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
..... unit ΣI0..1stringUnit representation
..... system ΣI0..1uriSystem that defines coded unit form
..... code ΣI0..1codeCoded form of the unit
.... stratifier I0..*BackboneElementStratification results
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code I0..*CodeableConceptWhat stratifier of the group
..... stratum I0..*BackboneElementStratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... value I0..1CodeableConceptThe stratum value, e.g. male
...... component I0..*BackboneElementStratifier component values
....... id 0..1stringUnique id for inter-element referencing
....... extension I0..*ExtensionAdditional content defined by implementations
....... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
....... code I1..1CodeableConceptWhat stratifier component of the group
....... value I1..1CodeableConceptThe stratum component value, e.g. male
...... population I0..*BackboneElementPopulation results in this stratum
....... id 0..1stringUnique id for inter-element referencing
....... extension I0..*ExtensionAdditional content defined by implementations
....... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
....... code I0..1CodeableConceptinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible)
....... count I0..1integerSize of the population
....... subjectResults I0..1Reference(List)For subject-list reports, the subject results in this population
...... measureScore I0..1QuantityWhat score this stratum achieved
... evaluatedResource SI0..*Reference(Resource)What data was used to calculate the measure score
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... extension-populationReference I0..*CodeableConceptPopulation reference
URL: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-populationReference
Binding: MeasurePopulationType (required)
.... reference ΣI0..1stringLiteral reference, Relative, internal or absolute URL
.... type ΣI0..1uriType the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible)
.... identifier ΣI0..1IdentifierLogical reference, when literal reference is not known
.... display ΣI0..1stringText alternative for the resource

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. MeasureReport I0..*DEQMIndividualMeasureReportProfileResults of a measure evaluation
... extension-measureScoring I0..1CodeableConceptExtension
URL: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring
... extension-reportingVendor I0..1Reference(DEQM Organization Profile)Vendor information
URL: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-reportingVendor
... extension-certificationIdentifier I0..1IdentifierCMS EHR Certifciation ID
URL: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-certificationIdentifier
.... value[x]:valueIdentifier I1..1IdentifierValue of extension
Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... use0..1codeusual | official | temp | secondary | old (If known)
..... type0..1CodeableConceptDescription of identifier
..... system1..1uriThe namespace for the identifier value
Fixed Value: urn:oid:2.16.840.1.113883.3.2074.1
..... value0..1stringThe value that is unique
..... period0..1PeriodTime period when id is/was valid for use
..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
... cqfm-softwaresystem I0..*Reference(CQFMDevice)Extension
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem
... status ?!ΣI1..1codecomplete | pending | error
Binding: MeasureReportStatus (required)
... type ΣI1..1codeindividual | subject-list | summary | data-collection
Binding: MeasureReportType (required)
Fixed Value: individual
... measure ΣI1..1canonical(Measure)What measure was calculated
... subject ΣI1..1Reference(QICorePatient)What individual(s) the report is for
... date ΣI1..1dateTimeWhen the report was generated
... reporter ΣI1..1Reference(DEQM Organization Profile)The organization where the measure was completed
... period ΣI1..1PeriodWhat period the report covers
deqm-1: Date precision SHALL be at least to day ( YYYY-MM-DD )
.... start ΣI1..1dateTimeStarting time with inclusive boundary
.... end ΣI1..1dateTimeEnd time with inclusive boundary, if not ongoing
... improvementNotation ?!ΣI0..1CodeableConceptincrease | decrease
Binding: MeasureImprovementNotation (required)
... group I0..*BackboneElementMeasure results for each group
.... id 0..1stringUnique id for inter-element referencing
.... population I1..*BackboneElementThe populations in the group
..... code ΣI1..1CodeableConceptinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible)
..... count I0..1integerSize of the population
.... measureScore ΣI1..1QuantityWhat score this group achieved
..... extension-alternateScoreType I0..1dateTime, CodeableConcept, Period, Range, DurationPossible additional measureScore value types
URL: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-alternateScoreType
... evaluatedResource I0..*Reference(Resource)What data was used to calculate the measure score

doco Documentation for this format

This structure is derived from DEQMIndividualMeasureReportProfile

Summary

Must-Support: 1 element

Extensions

This structure refers to these extensions:

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MeasureReport I0..*DEQMIndividualMeasureReportProfileResults of a measure evaluation
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionExtension
Slice: Unordered, Open by value:url
... extension-measureScoring SI0..1CodeableConceptExtension
URL: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring
... extension-reportingVendor SI0..1Reference(DEQM Organization Profile)Vendor information
URL: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-reportingVendor
... extension-certificationIdentifier SI0..1IdentifierCMS EHR Certifciation ID
URL: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-certificationIdentifier
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... url 1..1uri"http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-certificationIdentifier"
.... value[x] I1..1(Slice Definition)Value of extension
Slice: Unordered, Closed by type:$this
..... value[x]:valueIdentifier SI1..1IdentifierValue of extension
Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... use0..1codeusual | official | temp | secondary | old (If known)
...... type0..1CodeableConceptDescription of identifier
...... system1..1uriThe namespace for the identifier value
Fixed Value: urn:oid:2.16.840.1.113883.3.2074.1
...... value0..1stringThe value that is unique
...... period0..1PeriodTime period when id is/was valid for use
...... assigner0..1Reference(Organization)Organization that issued id (may be just text)
... cqfm-softwaresystem SI0..*Reference(CQFMDevice)Extension
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierAdditional identifier for the MeasureReport
... status ?!SΣI1..1codecomplete | pending | error
Binding: MeasureReportStatus (required)
... type SΣI1..1codeindividual | subject-list | summary | data-collection
Binding: MeasureReportType (required)
Fixed Value: individual
... measure SΣI1..1canonical(Measure)What measure was calculated
... subject SΣI1..1Reference(QICorePatient)What individual(s) the report is for
... date SΣI1..1dateTimeWhen the report was generated
... reporter SΣI1..1Reference(DEQM Organization Profile)The organization where the measure was completed
... period SΣI1..1PeriodWhat period the report covers
deqm-1: Date precision SHALL be at least to day ( YYYY-MM-DD )
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... start SΣI1..1dateTimeStarting time with inclusive boundary
.... end SΣI1..1dateTimeEnd time with inclusive boundary, if not ongoing
... improvementNotation ?!SΣI0..1CodeableConceptincrease | decrease
Binding: MeasureImprovementNotation (required)
... group SI0..*BackboneElementMeasure results for each group
.... id S0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code ΣI0..1CodeableConceptMeaning of the group
.... population SI1..*BackboneElementThe populations in the group
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code SΣI1..1CodeableConceptinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible)
..... count SI0..1integerSize of the population
.... measureScore SΣI1..1QuantityWhat score this group achieved
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... extension-alternateScoreType SI0..1dateTime, CodeableConcept, Period, Range, DurationPossible additional measureScore value types
URL: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-alternateScoreType
..... value ΣI0..1decimalNumerical value (with implicit precision)
..... comparator ?!ΣI0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required)
..... unit ΣI0..1stringUnit representation
..... system ΣI0..1uriSystem that defines coded unit form
..... code ΣI0..1codeCoded form of the unit
.... stratifier I0..*BackboneElementStratification results
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code I0..*CodeableConceptWhat stratifier of the group
..... stratum I0..*BackboneElementStratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... value I0..1CodeableConceptThe stratum value, e.g. male
...... component I0..*BackboneElementStratifier component values
....... id 0..1stringUnique id for inter-element referencing
....... extension I0..*ExtensionAdditional content defined by implementations
....... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
....... code I1..1CodeableConceptWhat stratifier component of the group
....... value I1..1CodeableConceptThe stratum component value, e.g. male
...... population I0..*BackboneElementPopulation results in this stratum
....... id 0..1stringUnique id for inter-element referencing
....... extension I0..*ExtensionAdditional content defined by implementations
....... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
....... code I0..1CodeableConceptinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible)
....... count I0..1integerSize of the population
....... subjectResults I0..1Reference(List)For subject-list reports, the subject results in this population
...... measureScore I0..1QuantityWhat score this stratum achieved
... evaluatedResource SI0..*Reference(Resource)What data was used to calculate the measure score
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... extension-populationReference I0..*CodeableConceptPopulation reference
URL: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-populationReference
Binding: MeasurePopulationType (required)
.... reference ΣI0..1stringLiteral reference, Relative, internal or absolute URL
.... type ΣI0..1uriType the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible)
.... identifier ΣI0..1IdentifierLogical reference, when literal reference is not known
.... display ΣI0..1stringText alternative for the resource

doco Documentation for this format

 

Other representations of profile: Schematron

Terminology Bindings

PathConformanceValueSet / Code
MeasureReport.languagepreferredCommonLanguages
Max Binding: AllLanguages
MeasureReport.statusrequiredMeasureReportStatus
MeasureReport.typerequiredFixed Value: individual
MeasureReport.improvementNotationrequiredMeasureImprovementNotation
MeasureReport.group.population.codeextensibleMeasurePopulationType
MeasureReport.group.measureScore.comparatorrequiredQuantityComparator
MeasureReport.group.stratifier.stratum.population.codeextensibleMeasurePopulationType
MeasureReport.evaluatedResource.typeextensibleResourceType

Constraints

IdPathDetailsRequirements
deqm-1MeasureReport.periodDate precision SHALL be at least to day ( YYYY-MM-DD )
: start.matches('^([0-9]{4})(-)(1[0-2]|0[1-9])-(3[01]|0[1-9]|[12][0-9]).*') and end.matches('^([0-9]{4})(-)(1[0-2]|0[1-9])-(3[01]|0[1-9]|[12][0-9]).*')

Notes:

ONLY the new content for Gaps in Care is in the scope for ballot for the September, 2020 Ballot Cycle.

Notes

This profile is used in the following transactions:

Individual Measure Reporting Interactions