Data Exchange For Quality Measures Implementation Guide
5.0.0 - STU5 United States of America flag

This page is part of the Da Vinci Data Exchange for Quality Measures (DEQM) FHIR IG (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

Resource Profile: DEQMSubjectListMeasureReport - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 4

Definitions for the subjectlist-measurereport-deqm resource profile.

Guidance on how to interpret the contents of this table can be found here

0. MeasureReport
Definition

The MeasureReport resource contains the results of the calculation of a measure; and optionally a reference to the resources involved in that calculation.

ShortResults of a measure evaluation
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information ((type != 'data-collection') or group.exists().not())
mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components (group.stratifier.stratum.all(value.exists() xor component.exists()))
deqm-2: If the measure scoring is specified at the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required ((extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists() and extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable')) implies improvementNotation.exists())
deqm-3: Measure scoring is required. It must be specified on the root only, or on every group, and it cannot be on both. ((extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists() and group.extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').empty()) xor (extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').empty() and group.all(extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists())))
mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information ((type != 'data-collection') or group.exists().not())
mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components (group.stratifier.stratum.all(value.exists() xor component.exists()))
2. MeasureReport.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. MeasureReport.extension:reportingProgram
Slice NamereportingProgram
Definition

Reference the reporting program by referencing their unique id specified in a Library resource that conforms to the Quality Program profile.

ShortReporting program
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(DEQM Reporting Program Extension) (Extension Type: Choice of: Identifier, canonical(CRMI Manifest Library))
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. MeasureReport.extension:category
Slice Namecategory
Definition

Specifies the category of a measure report.

ShortWhat category is this measure report
Control0..1
TypeExtension(Measure Report Category) (Extension Type: CodeableConcept)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. MeasureReport.extension:inputParameters
Slice NameinputParameters
Definition

Specifies the input parameters to the operation (such as a test case description or a data requirements or evaluate operation). This extension can be used as part of the result of an operation to indicate what the parameters were, but it can also be used as part of the definition of a test case to specify what the input parameters are expected to be for the test case.

ShortWhat parameters
Control0..1
TypeExtension(Input parameters) (Extension Type: Reference(Parameters))
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. MeasureReport.extension:supplementalData
Slice NamesupplementalData
Definition

Optional Extension Element - found in all resources.

ShortOptional Extensions Element
Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(Extension Definition for MeasureReport.supplementalData for Version 5.0) (Extension Type: Reference(Resource))
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. MeasureReport.extension:supplementalData.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..0*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on MeasureReport.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 14. MeasureReport.extension:supplementalData.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

    Control1..1
    Typeuri
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.supplementalData
    16. MeasureReport.extension:supplementalData.value[x]
    Definition

    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

    ShortValue of extension
    Control10..1
    TypeReference(Resource), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. MeasureReport.extension:supplementalData.value[x].extension:criteriaReference
    Slice NamecriteriaReference
    Definition

    Reference a criteria by specifying that criteria's unique id

    ShortCriteria reference
    Comments

    When used in a MeasureReport, this is a reference to the id of a criteria within the Measure referenced by the MeasureReport.

    Control0..1
    TypeExtension(Criteria Reference Extension) (Extension Type: string)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    20. MeasureReport.extension:supplementalData.value[x].extension:description
    Slice Namedescription
    Definition

    A description of the group, population, stratifier, or supplemental data definition on which it appears. This is typically a restatement of the description of the corresponding element in the Measure being reported, but may also include additional information gathered by the reporting process.

    ShortDescription of the supplemental data
    Control0..1
    TypeExtension(Measure Report Population Description) (Extension Type: markdown)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    22. MeasureReport.extension:scoring
    Slice Namescoring
    Definition

    Optional Extension Element - found in all resources.

    Shortproportion | ratio | continuous-variable | cohort | composite | attestation
    Control0..1
    This element is affected by the following invariants: ele-1, deqm-2, deqm-3, deqm-6
    TypeExtension(DEQM Measure Scoring Extension) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    24. MeasureReport.extension:vendor
    Slice Namevendor
    Definition

    A reference to the vendor who queried the data, calculated results and/or generated the report.

    ShortVendor information
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(DEQM Reporting Vendor Extension) (Extension Type: Reference(QICore Organization))
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    26. MeasureReport.extension:location
    Slice Namelocation
    Definition

    Location from which reported data was gathered. This extension is used to provide the location(s) from which reported data was gathered in a MeasureReport, such as individual, summary and data exchange measure report.

    ShortLocation(s) from which reported data was gathered
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(DEQM Data Location Extension) (Extension Type: Reference(QICore Location))
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    28. MeasureReport.extension:cehrt
    Slice Namecehrt
    Definition

    An identifier that represents the EHR certication number (CERHT). See Certified EHR Technology For more information.

    ShortCMS EHR Certification ID
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(DEQM Certification Identifier Extension) (Extension Type: Identifier)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    30. MeasureReport.extension:cehrt.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

    Control1..1
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    Fixed Valuehttp://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-certificationIdentifier
    32. MeasureReport.extension:cehrt.value[x]
    Definition

    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

    ShortValue of extension
    Control10..1
    TypeIdentifier, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on MeasureReport.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
    • type @ $this
    • 34. MeasureReport.extension:cehrt.value[x]:valueIdentifier
      Slice NamevalueIdentifier
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Control10..1
      TypeIdentifier, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summaryfalse
      Pattern Value{
        "system" : "urn:oid:2.16.840.1.113883.3.2074.1"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. MeasureReport.extension:software
      Slice Namesoftware
      Definition

      Specifies the software systems used in the packaging and testing of knowledge artifacts. Specifically to support explicitly stating which versions of the various software components were used in the authoring, packaging, and testing.

      ShortExtension
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeExtension(CRMI Software System) (Extension Type: Reference(CRMI Software System Device))
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      38. MeasureReport.extension:message
      Slice Namemessage
      Definition

      An OperationOutcome resource with information, warning, or error messages that were generated as part of processing an operation.

      ShortMessages encountered while creating the report
      Control0..1
      TypeExtension(Messages) (Extension Type: Reference(OperationOutcome))
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      40. MeasureReport.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      42. MeasureReport.status
      Definition

      The MeasureReport status. No data will be available until the MeasureReport status is complete.

      Shortcomplete | pending | error
      Comments

      This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

      Control1..1
      BindingThe codes SHALL be taken from MeasureReportStatushttp://hl7.org/fhir/ValueSet/measure-report-status|4.0.1
      (required to http://hl7.org/fhir/ValueSet/measure-report-status)
      Typecode
      Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. MeasureReport.type
      Definition

      The type of measure report. This may be an individual report, which provides the score for the measure for an individual member of the population; a subject-listing, which returns the list of members that meet the various criteria in the measure; a summary report, which returns a population count for each of the criteria in the measure; or a data-collection, which enables the MeasureReport to be used to exchange the data-of-interest for a quality measure.

      Shortindividual | subject-list | summary | data-collection
      Comments

      Data-collection reports are used only to communicate data-of-interest for a measure. They do not necessarily include all the data for a particular subject or population, but they may.

      Control1..1
      This element is affected by the following invariants: mrp-1
      BindingThe codes SHALL be taken from MeasureReportTypehttp://hl7.org/fhir/ValueSet/measure-report-type|4.0.1
      (required to http://hl7.org/fhir/ValueSet/measure-report-type|4.0.1)

      The type of the measure report.

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Requirements

      For subject-list quality meaure reporting, this report is constrained to reporting on a list of individuals, which also provides individual MeasureReports for the patients on the list.

      Fixed Valuesubject-list
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. MeasureReport.measure
      Definition

      A reference to the Measure that was calculated to produce this report.

      ShortWhat measure and version was calculatedWhat measure was calculated
      Control1..1
      This element is affected by the following invariants: deqm-0
      Typecanonical(CRMI Shareable Measure, Measure)
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Requirements

      This will indicate the measure being reported on. For example, the cannonical uri location for the MRP measure.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      deqm-0: Canonical URL SHALL contain a version. (%resource.measure.toString().contains('|') and %resource.measure.substring(%resource.measure.toString().indexOf('|') + 1).length() > 0)
      48. MeasureReport.subject
      Definition

      Optional subject identifying the individual or individuals the report is for.

      ShortWhat individual(s) the report is for
      Control0..1
      TypeReference(Group, Patient, Practitioner, PractitionerRole, Location, Device, RelatedPerson)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. MeasureReport.date
      Definition

      The date this measure report was generated.

      ShortWhen the report was generated. Note: The language in R5 was changed to calculated. We are clarifying that intent.
      Control10..1
      TypedateTime
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      52. MeasureReport.reporter
      Definition

      Organization that generated the MeasureReport.


      The individual, location, or organization that is reporting the data.

      ShortOrganization that generated the MeasureReportWho is reporting the data
      Control10..1
      TypeReference(QICore Organization, Practitioner, PractitionerRole, Location, Organization)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      54. MeasureReport.reporter.extension:group
      Slice Namegroup
      Definition

      Group of practitioners responsible for a report. This extension is used to provide the capability to allow the participating practitioners to be documented.

      ShortGroup of practitioners responsible for a report
      Control0..1
      TypeExtension(DEQM Reporter Group Extension) (Extension Type: Reference(Group))
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      56. MeasureReport.period
      Definition

      The reporting period for which the report was calculated.

      ShortWhat period the report covers
      Control1..1
      This element is affected by the following invariants: deqm-1
      TypePeriod
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      deqm-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) (start.toString().length()>9 and end.toString().length()>9)
      58. MeasureReport.period.start
      Definition

      The start of the period. The boundary is inclusive.

      ShortStarting time with inclusive boundary
      Comments

      If the low element is missing, the meaning is that the low boundary is not known.

      Control10..1
      This element is affected by the following invariants: per-1
      TypedateTime
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      60. MeasureReport.period.end
      Definition

      The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

      ShortEnd time with inclusive boundary, if not ongoing
      Comments

      The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

      Control10..1
      This element is affected by the following invariants: per-1
      TypedateTime
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      62. MeasureReport.improvementNotation
      Definition

      Whether improvement in the measure is noted by an increase or decrease in the measure score.

      Shortincrease | decrease
      Comments

      This element is typically defined by the measure, but reproduced here to ensure the measure score can be interpreted. The element is labeled as a modifier because it changes the interpretation of the reported measure score.

      Control0..1
      This element is affected by the following invariants: deqm-2
      BindingThe codes SHALL be taken from MeasureImprovementNotationhttp://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.1
      (required to http://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.1)

      Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.

      TypeCodeableConcept
      Is Modifiertrue because Improvement notation determines how to interpret the measure score (i.e. whether an increase is an improvement)
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      64. MeasureReport.group
      Definition

      The results of the calculation, one for each population group in the measure.

      ShortMeasure results for each group
      Control10..*
      This element is affected by the following invariants: mrp-1
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      deqm-4: If the measure scoring is specified on the group and the scoring type is 'proportion', 'ratio' or 'continuous-variable' then the groupImprovementNotation element is required. ((extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists() and extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable')) implies extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-groupImprovementNotation').exists())
      deqm-6: If the measure scoring type is 'proportion' then the measureScore SHALL be a numerical value between 0 and 1 ((%resource.extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains 'proportion' or extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains 'proportion') implies (measureScore.value >= 0.0 and measureScore.value <= 1.0))
      66. MeasureReport.group.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      Must Supporttrue
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      68. MeasureReport.group.extension:scoring
      Slice Namescoring
      Definition

      Optional Extension Element - found in all resources.

      Shortproportion | ratio | continuous-variable | cohort | composite | attestation
      Control0..1
      This element is affected by the following invariants: ele-1, deqm-3
      TypeExtension(DEQM Measure Scoring Extension) (Extension Type: CodeableConcept)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      70. MeasureReport.group.extension:calculatedDate
      Slice NamecalculatedDate
      Definition

      This applies to the date this metric was actually calculated. If your measure calculation draws on stored calculations and there are multiple calculation dates, this extension would not apply, as in the example of a composite measure where the individual measures were calculated on different dates. This would only cover the case where there is only one calculation date.

      ShortThe date the score was calculated
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(DEQM Calculated Date Extension) (Extension Type: dateTime)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      72. MeasureReport.group.extension:improvementNotation
      Slice NameimprovementNotation
      Definition

      Optional Extension Element - found in all resources.

      Shortincrease | decrease
      Control0..1
      This element is affected by the following invariants: ele-1, deqm-4
      TypeExtension(DEQM Group Improvement Notation Extension) (Extension Type: CodeableConcept)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      74. MeasureReport.group.extension:description
      Slice Namedescription
      Definition

      A description of the group, population, stratifier, or supplemental data definition on which it appears. This is typically a restatement of the description of the corresponding element in the Measure being reported, but may also include additional information gathered by the reporting process.

      ShortDescription of the group
      Control0..1
      TypeExtension(Measure Report Population Description) (Extension Type: markdown)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      76. MeasureReport.group.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      78. MeasureReport.group.code
      Definition

      The meaning of the population group as defined in the measure definition.

      ShortMeaning of the group
      Control0..1
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      80. MeasureReport.group.population
      Definition

      The populations that make up the population group, one for each type of population appropriate for the measure.

      ShortThe populations in the group
      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      deqm-8: The population must either have a count (integer) or a countQuantity (quantity), but not both. (extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists())
      82. MeasureReport.group.population.extension:countQuantity
      Slice NamecountQuantity
      Definition

      The count of the population represented as a Quantity. This is used in cases where the count may be a decimal value such as in a ratio measure.

      ShortCount as a Quantity
      Control0..1
      This element is affected by the following invariants: deqm-8
      TypeExtension(Count Quantity) (Extension Type: Quantity)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      84. MeasureReport.group.population.extension:description
      Slice Namedescription
      Definition

      A description of the group, population, stratifier, or supplemental data definition on which it appears. This is typically a restatement of the description of the corresponding element in the Measure being reported, but may also include additional information gathered by the reporting process.

      ShortDescription of the population
      Control0..1
      TypeExtension(Measure Report Population Description) (Extension Type: markdown)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      86. MeasureReport.group.population.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      88. MeasureReport.group.population.code
      Definition

      The type of the population.

      Shortinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      Control10..1
      BindingUnless not suitable, these codes SHALL be taken from MeasurePopulationTypehttp://hl7.org/fhir/ValueSet/measure-population
      (extensible to http://hl7.org/fhir/ValueSet/measure-population)

      The type of population (e.g. initial, numerator, denominator, etc.).

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      90. MeasureReport.group.population.count
      Definition

      The number of members of the population.

      ShortSize of the population
      Control0..1
      This element is affected by the following invariants: deqm-8
      Typeinteger
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      92. MeasureReport.group.population.subjectResults
      Definition

      This element refers to a List of subject level MeasureReport resources, one for each subject in this population.

      ShortFor subject-list reports, the subject results in this population
      Control10..1
      TypeReference(DEQM Individual MeasureReport List, List)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      94. MeasureReport.group.measureScore
      Definition

      The measure score for this population group, calculated as appropriate for the measure type and scoring method, and based on the contents of the populations defined in the group.

      ShortWhat score this group achieved
      Control0..1
      This element is affected by the following invariants: deqm-6
      TypeQuantity
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      96. MeasureReport.group.measureScore.extension:alternateScoreType
      Slice NamealternateScoreType
      Definition

      Possible value types for the measureScore elements in addition to the standard Quantity type. The alternate type is determined by the Quality Measure Aggregate Method extension used on the Measure. The reported type of the measureScore for continuous variable measures is determined by the result type of the aggregate method operation.

      ShortPossible additional measureScore value types
      Comments

      This extension corresponds to the additional MeasureScore type added to the R5 version of MeasureReport.

      Control0..1
      TypeExtension(DEQM Alternate Score Type Extension) (Extension Type: Choice of: dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      98. MeasureReport.group.measureScore.comparator
      Definition

      How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

      Short< | <= | >= | > - how to understand the value
      Control0..1
      BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
      (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

      How the Quantity should be understood and represented.

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

      Meaning if MissingIf there is no comparator, then there is no modification of the value
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      100. MeasureReport.group.stratifier
      Definition

      When a measure includes multiple stratifiers, there will be a stratifier group for each stratifier defined by the measure.

      ShortStratification results
      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      deqm-7: If group.stratifier exists, then either group.stratifier.code or the group.stratifier.stratum.component.code is present, but not both (code.exists() xor stratum.component.exists())
      102. MeasureReport.group.stratifier.extension:description
      Slice Namedescription
      Definition

      A description of the group, population, stratifier, or supplemental data definition on which it appears. This is typically a restatement of the description of the corresponding element in the Measure being reported, but may also include additional information gathered by the reporting process.

      ShortDescription of the stratifier
      Control0..1
      TypeExtension(Measure Report Population Description) (Extension Type: markdown)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      104. MeasureReport.group.stratifier.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      106. MeasureReport.group.stratifier.code
      Definition

      The meaning of this stratifier, as defined in the measure definition.

      ShortWhat stratifier of the group
      Control0..1*
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      108. MeasureReport.group.stratifier.stratum
      Definition

      This element contains the results for a single stratum within the stratifier. For example, when stratifying on administrative gender, there will be four strata, one for each possible gender value.

      ShortStratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      110. MeasureReport.group.stratifier.stratum.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      112. MeasureReport.group.stratifier.stratum.value
      Definition

      The value for this stratum, expressed as a CodeableConcept. When defining stratifiers on complex values, the value must be rendered such that the value for each stratum within the stratifier is unique.

      ShortThe stratum value, e.g. male
      Control0..1
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      114. MeasureReport.group.stratifier.stratum.population
      Definition

      The populations that make up the stratum, one for each type of population appropriate to the measure.

      ShortPopulation results in this stratum
      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      deqm-9: The stratum population must either have a count (integer) or a countQuantity (quantity), but not both. (extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists())
      116. MeasureReport.group.stratifier.stratum.population.extension:countQuantity
      Slice NamecountQuantity
      Definition

      A Quantity representing the size of the population. This is important to support the case when a population value may result in a decimal when reporting composite measures.

      ShortSize of the population as a quantity.
      Control0..1
      TypeExtension(Count Quantity) (Extension Type: Quantity)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      118. MeasureReport.group.stratifier.stratum.population.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      120. MeasureReport.group.stratifier.stratum.population.code
      Definition

      The type of the population.

      Shortinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      Control10..1
      BindingUnless not suitable, these codes SHALL be taken from MeasurePopulationTypehttp://hl7.org/fhir/ValueSet/measure-population
      (extensible to http://hl7.org/fhir/ValueSet/measure-population)

      The type of population (e.g. initial, numerator, denominator, etc.).

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      122. MeasureReport.group.stratifier.stratum.population.count
      Definition

      The number of members of the population in this stratum.

      ShortSize of the population
      Control10..1
      This element is affected by the following invariants: deqm-9
      Typeinteger
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      124. MeasureReport.group.stratifier.stratum.population.subjectResults
      Definition

      This element refers to a List of subject level MeasureReport resources, one for each subject in this population in this stratum.

      ShortFor subject-list reports, the subject results in this population
      Control10..1
      TypeReference(DEQM Individual MeasureReport List, List)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      126. MeasureReport.group.stratifier.stratum.measureScore
      Definition

      The measure score for this stratum, calculated as appropriate for the measure type and scoring method, and based on only the members of this stratum.

      ShortWhat score this stratum achieved
      Control0..1
      TypeQuantity
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      128. MeasureReport.group.stratifier.stratum.measureScore.extension:alternateScoreType
      Slice NamealternateScoreType
      Definition

      Possible value types for the measureScore elements in addition to the standard Quantity type. The alternate type is determined by the Quality Measure Aggregate Method extension used on the Measure. The reported type of the measureScore for continuous variable measures is determined by the result type of the aggregate method operation.

      ShortPossible additional measureScore value types
      Comments

      This extension corresponds to the additional MeasureScore type added to the R5 version of MeasureReport.

      Control0..1
      TypeExtension(DEQM Alternate Score Type Extension) (Extension Type: Choice of: dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      130. MeasureReport.group.stratifier.stratum.measureScore.comparator
      Definition

      How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

      Short< | <= | >= | > - how to understand the value
      Control0..1
      BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
      (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

      How the Quantity should be understood and represented.

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

      Meaning if MissingIf there is no comparator, then there is no modification of the value
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      132. MeasureReport.evaluatedResource
      Definition

      A reference to a Bundle containing the Resources that were used in the calculation of this measure.

      ShortWhat data was used to calculate the measure score
      Control0..0*
      TypeReference(Resource)
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Guidance on how to interpret the contents of this table can be found here

      0. MeasureReport
      Must Supportfalse
      Invariantsdeqm-2: If the measure scoring is specified at the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required ((extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists() and extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable')) implies improvementNotation.exists())
      deqm-3: Measure scoring is required. It must be specified on the root only, or on every group, and it cannot be on both. ((extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists() and group.extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').empty()) xor (extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').empty() and group.all(extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists())))
      2. MeasureReport.extension:reportingProgram
      Slice NamereportingProgram
      Control0..1
      TypeExtension(DEQM Reporting Program Extension) (Extension Type: Choice of: Identifier, canonical(CRMI Manifest Library))
      4. MeasureReport.extension:category
      Slice Namecategory
      Control0..1
      TypeExtension(Measure Report Category) (Extension Type: CodeableConcept)
      Must Supporttrue
      6. MeasureReport.extension:inputParameters
      Slice NameinputParameters
      Control0..1
      TypeExtension(Input parameters) (Extension Type: Reference(Parameters))
      8. MeasureReport.extension:supplementalData
      Slice NamesupplementalData
      Control0..*
      TypeExtension(Extension Definition for MeasureReport.supplementalData for Version 5.0) (Extension Type: Reference(Resource))
      Must Supporttrue
      10. MeasureReport.extension:supplementalData.value[x]
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      12. MeasureReport.extension:supplementalData.value[x].extension:criteriaReference
      Slice NamecriteriaReference
      Control0..1
      TypeExtension(Criteria Reference Extension) (Extension Type: string)
      Must Supporttrue
      14. MeasureReport.extension:supplementalData.value[x].extension:description
      Slice Namedescription
      ShortDescription of the supplemental data
      Control0..1
      TypeExtension(Measure Report Population Description) (Extension Type: markdown)
      Must Supporttrue
      16. MeasureReport.extension:scoring
      Slice Namescoring
      Shortproportion | ratio | continuous-variable | cohort | composite | attestation
      Control0..1
      This element is affected by the following invariants: deqm-2, deqm-3, deqm-6
      TypeExtension(DEQM Measure Scoring Extension) (Extension Type: CodeableConcept)
      Must Supporttrue
      18. MeasureReport.extension:vendor
      Slice Namevendor
      Control0..1
      TypeExtension(DEQM Reporting Vendor Extension) (Extension Type: Reference(QICore Organization))
      20. MeasureReport.extension:location
      Slice Namelocation
      Control0..*
      TypeExtension(DEQM Data Location Extension) (Extension Type: Reference(QICore Location))
      22. MeasureReport.extension:cehrt
      Slice Namecehrt
      ShortCMS EHR Certification ID
      Control0..1
      TypeExtension(DEQM Certification Identifier Extension) (Extension Type: Identifier)
      24. MeasureReport.extension:cehrt.valueIdentifier
      Control1..1
      TypeIdentifier
      Pattern Value{
        "system" : "urn:oid:2.16.840.1.113883.3.2074.1"
      }
      26. MeasureReport.extension:software
      Slice Namesoftware
      Control0..*
      TypeExtension(CRMI Software System) (Extension Type: Reference(CRMI Software System Device))
      28. MeasureReport.extension:message
      Slice Namemessage
      ShortMessages encountered while creating the report
      Control0..1
      TypeExtension(Messages) (Extension Type: Reference(OperationOutcome))
      30. MeasureReport.status
      BindingThe codes SHALL be taken from MeasureReportStatus
      (required to http://hl7.org/fhir/ValueSet/measure-report-status)
      Must Supporttrue
      32. MeasureReport.type
      Typecode
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Requirements

      For subject-list quality meaure reporting, this report is constrained to reporting on a list of individuals, which also provides individual MeasureReports for the patients on the list.

      Fixed Valuesubject-list
      34. MeasureReport.measure
      Definition

      A reference to the Measure that was calculated to produce this report.

      ShortWhat measure and version was calculated
      Typecanonical(CRMI Shareable Measure)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Requirements

      This will indicate the measure being reported on. For example, the cannonical uri location for the MRP measure.

      Invariantsdeqm-0: Canonical URL SHALL contain a version. (%resource.measure.toString().contains('|') and %resource.measure.substring(%resource.measure.toString().indexOf('|') + 1).length() > 0)
      36. MeasureReport.subject
      TypeReference(Group)
      Must Supporttrue
      38. MeasureReport.date
      ShortWhen the report was generated. Note: The language in R5 was changed to calculated. We are clarifying that intent.
      Control1..1
      Must Supporttrue
      40. MeasureReport.reporter
      Definition

      Organization that generated the MeasureReport.

      ShortOrganization that generated the MeasureReport
      Control1..1
      TypeReference(QICore Organization)
      Must Supporttrue
      42. MeasureReport.reporter.extension:group
      Slice Namegroup
      Control0..1
      TypeExtension(DEQM Reporter Group Extension) (Extension Type: Reference(Group))
      44. MeasureReport.period
      Control1..1
      This element is affected by the following invariants: deqm-1
      TypePeriod
      Must Supporttrue
      Invariantsdeqm-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) (start.toString().length()>9 and end.toString().length()>9)
      46. MeasureReport.period.start
      Control1..1
      Must Supporttrue
      48. MeasureReport.period.end
      Control1..1
      Must Supporttrue
      50. MeasureReport.improvementNotation
      Control0..1
      This element is affected by the following invariants: deqm-2
      Must Supporttrue
      52. MeasureReport.group
      Control1..*
      Must Supporttrue
      Invariantsdeqm-4: If the measure scoring is specified on the group and the scoring type is 'proportion', 'ratio' or 'continuous-variable' then the groupImprovementNotation element is required. ((extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists() and extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable')) implies extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-groupImprovementNotation').exists())
      deqm-6: If the measure scoring type is 'proportion' then the measureScore SHALL be a numerical value between 0 and 1 ((%resource.extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains 'proportion' or extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains 'proportion') implies (measureScore.value >= 0.0 and measureScore.value <= 1.0))
      54. MeasureReport.group.id
      Must Supporttrue
      56. MeasureReport.group.extension:scoring
      Slice Namescoring
      Shortproportion | ratio | continuous-variable | cohort | composite | attestation
      Control0..1
      This element is affected by the following invariants: deqm-3
      TypeExtension(DEQM Measure Scoring Extension) (Extension Type: CodeableConcept)
      Must Supporttrue
      58. MeasureReport.group.extension:calculatedDate
      Slice NamecalculatedDate
      Control0..1
      TypeExtension(DEQM Calculated Date Extension) (Extension Type: dateTime)
      Must Supporttrue
      60. MeasureReport.group.extension:improvementNotation
      Slice NameimprovementNotation
      Shortincrease | decrease
      Control0..1
      This element is affected by the following invariants: deqm-4
      TypeExtension(DEQM Group Improvement Notation Extension) (Extension Type: CodeableConcept)
      Must Supporttrue
      62. MeasureReport.group.extension:description
      Slice Namedescription
      ShortDescription of the group
      Control0..1
      TypeExtension(Measure Report Population Description) (Extension Type: markdown)
      Must Supporttrue
      64. MeasureReport.group.code
      Must Supporttrue
      66. MeasureReport.group.population
      Must Supporttrue
      Invariantsdeqm-8: The population must either have a count (integer) or a countQuantity (quantity), but not both. (extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists())
      68. MeasureReport.group.population.extension:countQuantity
      Slice NamecountQuantity
      Definition

      The count of the population represented as a Quantity. This is used in cases where the count may be a decimal value such as in a ratio measure.

      ShortCount as a Quantity
      Control0..1
      This element is affected by the following invariants: deqm-8
      TypeExtension(Count Quantity) (Extension Type: Quantity)
      Must Supporttrue
      70. MeasureReport.group.population.extension:description
      Slice Namedescription
      ShortDescription of the population
      Control0..1
      TypeExtension(Measure Report Population Description) (Extension Type: markdown)
      Must Supporttrue
      72. MeasureReport.group.population.code
      Control1..1
      Must Supporttrue
      74. MeasureReport.group.population.count
      Control0..1
      This element is affected by the following invariants: deqm-8
      Must Supporttrue
      76. MeasureReport.group.population.subjectResults
      Control1..?
      TypeReference(DEQM Individual MeasureReport List)
      Must Supporttrue
      78. MeasureReport.group.measureScore
      Control0..1
      This element is affected by the following invariants: deqm-6
      Must Supporttrue
      80. MeasureReport.group.measureScore.extension:alternateScoreType
      Slice NamealternateScoreType
      Control0..1
      TypeExtension(DEQM Alternate Score Type Extension) (Extension Type: Choice of: dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio)
      Must Supporttrue
      82. MeasureReport.group.stratifier
      Must Supporttrue
      Invariantsdeqm-7: If group.stratifier exists, then either group.stratifier.code or the group.stratifier.stratum.component.code is present, but not both (code.exists() xor stratum.component.exists())
      84. MeasureReport.group.stratifier.extension:description
      Slice Namedescription
      ShortDescription of the stratifier
      Control0..1
      TypeExtension(Measure Report Population Description) (Extension Type: markdown)
      Must Supporttrue
      86. MeasureReport.group.stratifier.code
      Control0..1
      Must Supporttrue
      88. MeasureReport.group.stratifier.stratum
      Must Supporttrue
      90. MeasureReport.group.stratifier.stratum.value
      Must Supporttrue
      92. MeasureReport.group.stratifier.stratum.population
      Must Supporttrue
      Invariantsdeqm-9: The stratum population must either have a count (integer) or a countQuantity (quantity), but not both. (extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists())
      94. MeasureReport.group.stratifier.stratum.population.extension:countQuantity
      Slice NamecountQuantity
      Control0..1
      TypeExtension(Count Quantity) (Extension Type: Quantity)
      Must Supporttrue
      96. MeasureReport.group.stratifier.stratum.population.code
      Control1..1
      Must Supporttrue
      98. MeasureReport.group.stratifier.stratum.population.count
      Control1..1
      This element is affected by the following invariants: deqm-9
      Must Supporttrue
      100. MeasureReport.group.stratifier.stratum.population.subjectResults
      Control1..1
      TypeReference(DEQM Individual MeasureReport List)
      Must Supporttrue
      102. MeasureReport.group.stratifier.stratum.measureScore
      Must Supporttrue
      104. MeasureReport.group.stratifier.stratum.measureScore.extension:alternateScoreType
      Slice NamealternateScoreType
      Control0..1
      TypeExtension(DEQM Alternate Score Type Extension) (Extension Type: Choice of: dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio)
      Must Supporttrue
      106. MeasureReport.evaluatedResource
      Control0..0
      Must Supportfalse

      Guidance on how to interpret the contents of this table can be found here

      0. MeasureReport
      Definition

      The MeasureReport resource contains the results of the calculation of a measure; and optionally a reference to the resources involved in that calculation.

      ShortResults of a measure evaluation
      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information ((type != 'data-collection') or group.exists().not())
      mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components (group.stratifier.stratum.all(value.exists() xor component.exists()))
      deqm-2: If the measure scoring is specified at the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required ((extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists() and extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable')) implies improvementNotation.exists())
      deqm-3: Measure scoring is required. It must be specified on the root only, or on every group, and it cannot be on both. ((extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists() and group.extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').empty()) xor (extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').empty() and group.all(extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists())))
      2. MeasureReport.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. MeasureReport.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. MeasureReport.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. MeasureReport.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

      Control0..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. MeasureReport.text
      Definition

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Comments

      Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. MeasureReport.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

      ShortContained, inline Resources
      Comments

      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

      Control0..*
      TypeResource
      Is Modifierfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. MeasureReport.extension
      Definition

      An Extension

      ShortExtension
      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on MeasureReport.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. MeasureReport.extension:reportingProgram
        Slice NamereportingProgram
        Definition

        Reference the reporting program by referencing their unique id specified in a Library resource that conforms to the Quality Program profile.

        ShortReporting program
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(DEQM Reporting Program Extension) (Extension Type: Choice of: Identifier, canonical(CRMI Manifest Library))
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        18. MeasureReport.extension:category
        Slice Namecategory
        Definition

        Specifies the category of a measure report.

        ShortWhat category is this measure report
        Control0..1
        TypeExtension(Measure Report Category) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        20. MeasureReport.extension:inputParameters
        Slice NameinputParameters
        Definition

        Specifies the input parameters to the operation (such as a test case description or a data requirements or evaluate operation). This extension can be used as part of the result of an operation to indicate what the parameters were, but it can also be used as part of the definition of a test case to specify what the input parameters are expected to be for the test case.

        ShortWhat parameters
        Control0..1
        TypeExtension(Input parameters) (Extension Type: Reference(Parameters))
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        22. MeasureReport.extension:supplementalData
        Slice NamesupplementalData
        Definition

        Optional Extension Element - found in all resources.

        ShortOptional Extensions Element
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(Extension Definition for MeasureReport.supplementalData for Version 5.0) (Extension Type: Reference(Resource))
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        24. MeasureReport.extension:supplementalData.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        26. MeasureReport.extension:supplementalData.extension
        Definition

        An Extension

        ShortExtension
        Control0..0
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on MeasureReport.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 28. MeasureReport.extension:supplementalData.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.supplementalData
          30. MeasureReport.extension:supplementalData.value[x]
          Definition

          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

          ShortValue of extension
          Control1..1
          TypeReference(Resource)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          32. MeasureReport.extension:supplementalData.value[x].id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          34. MeasureReport.extension:supplementalData.value[x].extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on MeasureReport.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 36. MeasureReport.extension:supplementalData.value[x].extension:criteriaReference
            Slice NamecriteriaReference
            Definition

            Reference a criteria by specifying that criteria's unique id

            ShortCriteria reference
            Comments

            When used in a MeasureReport, this is a reference to the id of a criteria within the Measure referenced by the MeasureReport.

            Control0..1
            TypeExtension(Criteria Reference Extension) (Extension Type: string)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            38. MeasureReport.extension:supplementalData.value[x].extension:description
            Slice Namedescription
            Definition

            A description of the group, population, stratifier, or supplemental data definition on which it appears. This is typically a restatement of the description of the corresponding element in the Measure being reported, but may also include additional information gathered by the reporting process.

            ShortDescription of the supplemental data
            Control0..1
            TypeExtension(Measure Report Population Description) (Extension Type: markdown)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            40. MeasureReport.extension:supplementalData.value[x].reference
            Definition

            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

            ShortLiteral reference, Relative, internal or absolute URL
            Comments

            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

            Control0..1
            This element is affected by the following invariants: ref-1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            42. MeasureReport.extension:supplementalData.value[x].type
            Definition

            The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

            The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

            ShortType the reference refers to (e.g. "Patient")
            Comments

            This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from ResourceType
            (extensible to http://hl7.org/fhir/ValueSet/resource-types)

            Aa resource (or, for logical models, the URI of the logical model).

            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            44. MeasureReport.extension:supplementalData.value[x].identifier
            Definition

            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

            ShortLogical reference, when literal reference is not known
            Comments

            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..1
            TypeIdentifier
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            46. MeasureReport.extension:supplementalData.value[x].display
            Definition

            Plain text narrative that identifies the resource in addition to the resource reference.

            ShortText alternative for the resource
            Comments

            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            48. MeasureReport.extension:scoring
            Slice Namescoring
            Definition

            Optional Extension Element - found in all resources.

            Shortproportion | ratio | continuous-variable | cohort | composite | attestation
            Control0..1
            This element is affected by the following invariants: ele-1, deqm-2, deqm-3, deqm-6
            TypeExtension(DEQM Measure Scoring Extension) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            50. MeasureReport.extension:vendor
            Slice Namevendor
            Definition

            A reference to the vendor who queried the data, calculated results and/or generated the report.

            ShortVendor information
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(DEQM Reporting Vendor Extension) (Extension Type: Reference(QICore Organization))
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            52. MeasureReport.extension:location
            Slice Namelocation
            Definition

            Location from which reported data was gathered. This extension is used to provide the location(s) from which reported data was gathered in a MeasureReport, such as individual, summary and data exchange measure report.

            ShortLocation(s) from which reported data was gathered
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(DEQM Data Location Extension) (Extension Type: Reference(QICore Location))
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            54. MeasureReport.extension:cehrt
            Slice Namecehrt
            Definition

            An identifier that represents the EHR certication number (CERHT). See Certified EHR Technology For more information.

            ShortCMS EHR Certification ID
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(DEQM Certification Identifier Extension) (Extension Type: Identifier)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            56. MeasureReport.extension:cehrt.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            58. MeasureReport.extension:cehrt.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on MeasureReport.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 60. MeasureReport.extension:cehrt.url
              Definition

              Source of the definition for the extension code - a logical name or a URL.

              Shortidentifies the meaning of the extension
              Comments

              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

              Control1..1
              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              Fixed Valuehttp://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-certificationIdentifier
              62. MeasureReport.extension:cehrt.value[x]
              Definition

              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

              ShortValue of extension
              Control1..1
              TypeIdentifier
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on MeasureReport.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
              • type @ $this
              • 64. MeasureReport.extension:cehrt.value[x]:valueIdentifier
                Slice NamevalueIdentifier
                Definition

                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                ShortValue of extension
                Control1..1
                TypeIdentifier
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Summaryfalse
                Pattern Value{
                  "system" : "urn:oid:2.16.840.1.113883.3.2074.1"
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                66. MeasureReport.extension:software
                Slice Namesoftware
                Definition

                Specifies the software systems used in the packaging and testing of knowledge artifacts. Specifically to support explicitly stating which versions of the various software components were used in the authoring, packaging, and testing.

                ShortExtension
                Control0..*
                This element is affected by the following invariants: ele-1
                TypeExtension(CRMI Software System) (Extension Type: Reference(CRMI Software System Device))
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                68. MeasureReport.extension:message
                Slice Namemessage
                Definition

                An OperationOutcome resource with information, warning, or error messages that were generated as part of processing an operation.

                ShortMessages encountered while creating the report
                Control0..1
                TypeExtension(Messages) (Extension Type: Reference(OperationOutcome))
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                70. MeasureReport.modifierExtension
                Definition

                May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                ShortExtensions that cannot be ignored
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                Summaryfalse
                Requirements

                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                72. MeasureReport.identifier
                Definition

                A formal identifier that is used to identify this MeasureReport when it is represented in other formats or referenced in a specification, model, design or an instance.

                ShortAdditional identifier for the MeasureReport
                Comments

                Typically, this is used for identifiers that can go in an HL7 V3 II data type - e.g. to identify this {{title}} outside of FHIR, where the logical URL is not possible to use.

                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..*
                TypeIdentifier
                Is Modifierfalse
                Summarytrue
                Requirements

                Allows externally provided and/or usable business identifiers to be easily associated with the module.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                74. MeasureReport.status
                Definition

                The MeasureReport status. No data will be available until the MeasureReport status is complete.

                Shortcomplete | pending | error
                Comments

                This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                Control1..1
                BindingThe codes SHALL be taken from MeasureReportStatus
                (required to http://hl7.org/fhir/ValueSet/measure-report-status)
                Typecode
                Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                76. MeasureReport.type
                Definition

                The type of measure report. This may be an individual report, which provides the score for the measure for an individual member of the population; a subject-listing, which returns the list of members that meet the various criteria in the measure; a summary report, which returns a population count for each of the criteria in the measure; or a data-collection, which enables the MeasureReport to be used to exchange the data-of-interest for a quality measure.

                Shortindividual | subject-list | summary | data-collection
                Comments

                Data-collection reports are used only to communicate data-of-interest for a measure. They do not necessarily include all the data for a particular subject or population, but they may.

                Control1..1
                This element is affected by the following invariants: mrp-1
                BindingThe codes SHALL be taken from MeasureReportType
                (required to http://hl7.org/fhir/ValueSet/measure-report-type|4.0.1)

                The type of the measure report.

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Requirements

                For subject-list quality meaure reporting, this report is constrained to reporting on a list of individuals, which also provides individual MeasureReports for the patients on the list.

                Fixed Valuesubject-list
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                78. MeasureReport.measure
                Definition

                A reference to the Measure that was calculated to produce this report.

                ShortWhat measure and version was calculated
                Control1..1
                This element is affected by the following invariants: deqm-0
                Typecanonical(CRMI Shareable Measure)
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Requirements

                This will indicate the measure being reported on. For example, the cannonical uri location for the MRP measure.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                deqm-0: Canonical URL SHALL contain a version. (%resource.measure.toString().contains('|') and %resource.measure.substring(%resource.measure.toString().indexOf('|') + 1).length() > 0)
                80. MeasureReport.subject
                Definition

                Optional subject identifying the individual or individuals the report is for.

                ShortWhat individual(s) the report is for
                Control0..1
                TypeReference(Group)
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                82. MeasureReport.date
                Definition

                The date this measure report was generated.

                ShortWhen the report was generated. Note: The language in R5 was changed to calculated. We are clarifying that intent.
                Control1..1
                TypedateTime
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                84. MeasureReport.reporter
                Definition

                Organization that generated the MeasureReport.

                ShortOrganization that generated the MeasureReport
                Control1..1
                TypeReference(QICore Organization)
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                86. MeasureReport.reporter.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                88. MeasureReport.reporter.extension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortAdditional content defined by implementations
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on MeasureReport.reporter.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 90. MeasureReport.reporter.extension:group
                  Slice Namegroup
                  Definition

                  Group of practitioners responsible for a report. This extension is used to provide the capability to allow the participating practitioners to be documented.

                  ShortGroup of practitioners responsible for a report
                  Control0..1
                  TypeExtension(DEQM Reporter Group Extension) (Extension Type: Reference(Group))
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  92. MeasureReport.reporter.reference
                  Definition

                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                  ShortLiteral reference, Relative, internal or absolute URL
                  Comments

                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                  Control0..1
                  This element is affected by the following invariants: ref-1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  94. MeasureReport.reporter.type
                  Definition

                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                  ShortType the reference refers to (e.g. "Patient")
                  Comments

                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                  Control0..1
                  BindingUnless not suitable, these codes SHALL be taken from ResourceType
                  (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                  Aa resource (or, for logical models, the URI of the logical model).

                  Typeuri
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  96. MeasureReport.reporter.identifier
                  Definition

                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                  ShortLogical reference, when literal reference is not known
                  Comments

                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..1
                  TypeIdentifier
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  98. MeasureReport.reporter.display
                  Definition

                  Plain text narrative that identifies the resource in addition to the resource reference.

                  ShortText alternative for the resource
                  Comments

                  This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  100. MeasureReport.period
                  Definition

                  The reporting period for which the report was calculated.

                  ShortWhat period the report covers
                  Control1..1
                  This element is affected by the following invariants: deqm-1
                  TypePeriod
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  deqm-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) (start.toString().length()>9 and end.toString().length()>9)
                  102. MeasureReport.period.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  104. MeasureReport.period.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on MeasureReport.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 106. MeasureReport.period.start
                    Definition

                    The start of the period. The boundary is inclusive.

                    ShortStarting time with inclusive boundary
                    Comments

                    If the low element is missing, the meaning is that the low boundary is not known.

                    Control1..1
                    This element is affected by the following invariants: per-1
                    TypedateTime
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    108. MeasureReport.period.end
                    Definition

                    The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                    ShortEnd time with inclusive boundary, if not ongoing
                    Comments

                    The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                    Control1..1
                    This element is affected by the following invariants: per-1
                    TypedateTime
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    110. MeasureReport.improvementNotation
                    Definition

                    Whether improvement in the measure is noted by an increase or decrease in the measure score.

                    Shortincrease | decrease
                    Comments

                    This element is typically defined by the measure, but reproduced here to ensure the measure score can be interpreted. The element is labeled as a modifier because it changes the interpretation of the reported measure score.

                    Control0..1
                    This element is affected by the following invariants: deqm-2
                    BindingThe codes SHALL be taken from MeasureImprovementNotation
                    (required to http://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.1)

                    Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.

                    TypeCodeableConcept
                    Is Modifiertrue because Improvement notation determines how to interpret the measure score (i.e. whether an increase is an improvement)
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    112. MeasureReport.group
                    Definition

                    The results of the calculation, one for each population group in the measure.

                    ShortMeasure results for each group
                    Control1..*
                    This element is affected by the following invariants: mrp-1
                    TypeBackboneElement
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    deqm-4: If the measure scoring is specified on the group and the scoring type is 'proportion', 'ratio' or 'continuous-variable' then the groupImprovementNotation element is required. ((extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists() and extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable')) implies extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-groupImprovementNotation').exists())
                    deqm-6: If the measure scoring type is 'proportion' then the measureScore SHALL be a numerical value between 0 and 1 ((%resource.extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains 'proportion' or extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains 'proportion') implies (measureScore.value >= 0.0 and measureScore.value <= 1.0))
                    114. MeasureReport.group.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Must Supporttrue
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    116. MeasureReport.group.extension
                    Definition

                    An Extension

                    ShortExtension
                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on MeasureReport.group.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 118. MeasureReport.group.extension:scoring
                      Slice Namescoring
                      Definition

                      Optional Extension Element - found in all resources.

                      Shortproportion | ratio | continuous-variable | cohort | composite | attestation
                      Control0..1
                      This element is affected by the following invariants: ele-1, deqm-3
                      TypeExtension(DEQM Measure Scoring Extension) (Extension Type: CodeableConcept)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      120. MeasureReport.group.extension:calculatedDate
                      Slice NamecalculatedDate
                      Definition

                      This applies to the date this metric was actually calculated. If your measure calculation draws on stored calculations and there are multiple calculation dates, this extension would not apply, as in the example of a composite measure where the individual measures were calculated on different dates. This would only cover the case where there is only one calculation date.

                      ShortThe date the score was calculated
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(DEQM Calculated Date Extension) (Extension Type: dateTime)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      122. MeasureReport.group.extension:improvementNotation
                      Slice NameimprovementNotation
                      Definition

                      Optional Extension Element - found in all resources.

                      Shortincrease | decrease
                      Control0..1
                      This element is affected by the following invariants: ele-1, deqm-4
                      TypeExtension(DEQM Group Improvement Notation Extension) (Extension Type: CodeableConcept)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      124. MeasureReport.group.extension:description
                      Slice Namedescription
                      Definition

                      A description of the group, population, stratifier, or supplemental data definition on which it appears. This is typically a restatement of the description of the corresponding element in the Measure being reported, but may also include additional information gathered by the reporting process.

                      ShortDescription of the group
                      Control0..1
                      TypeExtension(Measure Report Population Description) (Extension Type: markdown)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      126. MeasureReport.group.modifierExtension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                      ShortExtensions that cannot be ignored even if unrecognized
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      TypeExtension
                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                      Summarytrue
                      Requirements

                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                      Alternate Namesextensions, user content, modifiers
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      128. MeasureReport.group.code
                      Definition

                      The meaning of the population group as defined in the measure definition.

                      ShortMeaning of the group
                      Control0..1
                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      130. MeasureReport.group.population
                      Definition

                      The populations that make up the population group, one for each type of population appropriate for the measure.

                      ShortThe populations in the group
                      Control0..*
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      deqm-8: The population must either have a count (integer) or a countQuantity (quantity), but not both. (extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists())
                      132. MeasureReport.group.population.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      134. MeasureReport.group.population.extension
                      Definition

                      An Extension

                      ShortExtension
                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on MeasureReport.group.population.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 136. MeasureReport.group.population.extension:countQuantity
                        Slice NamecountQuantity
                        Definition

                        The count of the population represented as a Quantity. This is used in cases where the count may be a decimal value such as in a ratio measure.

                        ShortCount as a Quantity
                        Control0..1
                        This element is affected by the following invariants: deqm-8
                        TypeExtension(Count Quantity) (Extension Type: Quantity)
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        138. MeasureReport.group.population.extension:description
                        Slice Namedescription
                        Definition

                        A description of the group, population, stratifier, or supplemental data definition on which it appears. This is typically a restatement of the description of the corresponding element in the Measure being reported, but may also include additional information gathered by the reporting process.

                        ShortDescription of the population
                        Control0..1
                        TypeExtension(Measure Report Population Description) (Extension Type: markdown)
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        140. MeasureReport.group.population.modifierExtension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                        ShortExtensions that cannot be ignored even if unrecognized
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                        Summarytrue
                        Requirements

                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                        Alternate Namesextensions, user content, modifiers
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        142. MeasureReport.group.population.code
                        Definition

                        The type of the population.

                        Shortinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
                        Control1..1
                        BindingUnless not suitable, these codes SHALL be taken from MeasurePopulationType
                        (extensible to http://hl7.org/fhir/ValueSet/measure-population)

                        The type of population (e.g. initial, numerator, denominator, etc.).

                        TypeCodeableConcept
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        144. MeasureReport.group.population.count
                        Definition

                        The number of members of the population.

                        ShortSize of the population
                        Control0..1
                        This element is affected by the following invariants: deqm-8
                        Typeinteger
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        146. MeasureReport.group.population.subjectResults
                        Definition

                        This element refers to a List of subject level MeasureReport resources, one for each subject in this population.

                        ShortFor subject-list reports, the subject results in this population
                        Control1..1
                        TypeReference(DEQM Individual MeasureReport List)
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        148. MeasureReport.group.measureScore
                        Definition

                        The measure score for this population group, calculated as appropriate for the measure type and scoring method, and based on the contents of the populations defined in the group.

                        ShortWhat score this group achieved
                        Control0..1
                        This element is affected by the following invariants: deqm-6
                        TypeQuantity
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        150. MeasureReport.group.measureScore.id
                        Definition

                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        ShortUnique id for inter-element referencing
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        152. MeasureReport.group.measureScore.extension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                        ShortAdditional content defined by implementations
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingThis element introduces a set of slices on MeasureReport.group.measureScore.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 154. MeasureReport.group.measureScore.extension:alternateScoreType
                          Slice NamealternateScoreType
                          Definition

                          Possible value types for the measureScore elements in addition to the standard Quantity type. The alternate type is determined by the Quality Measure Aggregate Method extension used on the Measure. The reported type of the measureScore for continuous variable measures is determined by the result type of the aggregate method operation.

                          ShortPossible additional measureScore value types
                          Comments

                          This extension corresponds to the additional MeasureScore type added to the R5 version of MeasureReport.

                          Control0..1
                          TypeExtension(DEQM Alternate Score Type Extension) (Extension Type: Choice of: dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio)
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          156. MeasureReport.group.measureScore.value
                          Definition

                          The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                          ShortNumerical value (with implicit precision)
                          Comments

                          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                          Control0..1
                          Typedecimal
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Precision is handled implicitly in almost all cases of measurement.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          158. MeasureReport.group.measureScore.comparator
                          Definition

                          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                          Short< | <= | >= | > - how to understand the value
                          Control0..1
                          BindingThe codes SHALL be taken from QuantityComparator
                          (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                          How the Quantity should be understood and represented.

                          Typecode
                          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                          Meaning if MissingIf there is no comparator, then there is no modification of the value
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          160. MeasureReport.group.measureScore.unit
                          Definition

                          A human-readable form of the unit.

                          ShortUnit representation
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          162. MeasureReport.group.measureScore.system
                          Definition

                          The identification of the system that provides the coded form of the unit.

                          ShortSystem that defines coded unit form
                          Control0..1
                          This element is affected by the following invariants: qty-3
                          Typeuri
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Need to know the system that defines the coded form of the unit.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          164. MeasureReport.group.measureScore.code
                          Definition

                          A computer processable form of the unit in some unit representation system.

                          ShortCoded form of the unit
                          Comments

                          The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                          Control0..1
                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          166. MeasureReport.group.stratifier
                          Definition

                          When a measure includes multiple stratifiers, there will be a stratifier group for each stratifier defined by the measure.

                          ShortStratification results
                          Control0..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          deqm-7: If group.stratifier exists, then either group.stratifier.code or the group.stratifier.stratum.component.code is present, but not both (code.exists() xor stratum.component.exists())
                          168. MeasureReport.group.stratifier.id
                          Definition

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          170. MeasureReport.group.stratifier.extension
                          Definition

                          An Extension

                          ShortExtension
                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on MeasureReport.group.stratifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 172. MeasureReport.group.stratifier.extension:description
                            Slice Namedescription
                            Definition

                            A description of the group, population, stratifier, or supplemental data definition on which it appears. This is typically a restatement of the description of the corresponding element in the Measure being reported, but may also include additional information gathered by the reporting process.

                            ShortDescription of the stratifier
                            Control0..1
                            TypeExtension(Measure Report Population Description) (Extension Type: markdown)
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            174. MeasureReport.group.stratifier.modifierExtension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Summarytrue
                            Requirements

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                            Alternate Namesextensions, user content, modifiers
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            176. MeasureReport.group.stratifier.code
                            Definition

                            The meaning of this stratifier, as defined in the measure definition.

                            ShortWhat stratifier of the group
                            Control0..1
                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            178. MeasureReport.group.stratifier.stratum
                            Definition

                            This element contains the results for a single stratum within the stratifier. For example, when stratifying on administrative gender, there will be four strata, one for each possible gender value.

                            ShortStratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
                            Control0..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            180. MeasureReport.group.stratifier.stratum.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            182. MeasureReport.group.stratifier.stratum.extension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional content defined by implementations
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            184. MeasureReport.group.stratifier.stratum.modifierExtension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Summarytrue
                            Requirements

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                            Alternate Namesextensions, user content, modifiers
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            186. MeasureReport.group.stratifier.stratum.value
                            Definition

                            The value for this stratum, expressed as a CodeableConcept. When defining stratifiers on complex values, the value must be rendered such that the value for each stratum within the stratifier is unique.

                            ShortThe stratum value, e.g. male
                            Control0..1
                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            188. MeasureReport.group.stratifier.stratum.component
                            Definition

                            A stratifier component value.

                            ShortStratifier component values
                            Control0..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            190. MeasureReport.group.stratifier.stratum.component.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            192. MeasureReport.group.stratifier.stratum.component.extension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional content defined by implementations
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            194. MeasureReport.group.stratifier.stratum.component.modifierExtension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Summarytrue
                            Requirements

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                            Alternate Namesextensions, user content, modifiers
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            196. MeasureReport.group.stratifier.stratum.component.code
                            Definition

                            The code for the stratum component value.

                            ShortWhat stratifier component of the group
                            Control1..1
                            TypeCodeableConcept
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            198. MeasureReport.group.stratifier.stratum.component.value
                            Definition

                            The stratum component value.

                            ShortThe stratum component value, e.g. male
                            Control1..1
                            TypeCodeableConcept
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            200. MeasureReport.group.stratifier.stratum.population
                            Definition

                            The populations that make up the stratum, one for each type of population appropriate to the measure.

                            ShortPopulation results in this stratum
                            Control0..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            deqm-9: The stratum population must either have a count (integer) or a countQuantity (quantity), but not both. (extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists())
                            202. MeasureReport.group.stratifier.stratum.population.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            204. MeasureReport.group.stratifier.stratum.population.extension
                            Definition

                            An Extension

                            ShortExtension
                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on MeasureReport.group.stratifier.stratum.population.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 206. MeasureReport.group.stratifier.stratum.population.extension:countQuantity
                              Slice NamecountQuantity
                              Definition

                              A Quantity representing the size of the population. This is important to support the case when a population value may result in a decimal when reporting composite measures.

                              ShortSize of the population as a quantity.
                              Control0..1
                              TypeExtension(Count Quantity) (Extension Type: Quantity)
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              208. MeasureReport.group.stratifier.stratum.population.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                              Summarytrue
                              Requirements

                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                              Alternate Namesextensions, user content, modifiers
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              210. MeasureReport.group.stratifier.stratum.population.code
                              Definition

                              The type of the population.

                              Shortinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
                              Control1..1
                              BindingUnless not suitable, these codes SHALL be taken from MeasurePopulationType
                              (extensible to http://hl7.org/fhir/ValueSet/measure-population)

                              The type of population (e.g. initial, numerator, denominator, etc.).

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              212. MeasureReport.group.stratifier.stratum.population.count
                              Definition

                              The number of members of the population in this stratum.

                              ShortSize of the population
                              Control1..1
                              This element is affected by the following invariants: deqm-9
                              Typeinteger
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              214. MeasureReport.group.stratifier.stratum.population.subjectResults
                              Definition

                              This element refers to a List of subject level MeasureReport resources, one for each subject in this population in this stratum.

                              ShortFor subject-list reports, the subject results in this population
                              Control1..1
                              TypeReference(DEQM Individual MeasureReport List)
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              216. MeasureReport.group.stratifier.stratum.measureScore
                              Definition

                              The measure score for this stratum, calculated as appropriate for the measure type and scoring method, and based on only the members of this stratum.

                              ShortWhat score this stratum achieved
                              Control0..1
                              TypeQuantity
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              218. MeasureReport.group.stratifier.stratum.measureScore.id
                              Definition

                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              220. MeasureReport.group.stratifier.stratum.measureScore.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on MeasureReport.group.stratifier.stratum.measureScore.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 222. MeasureReport.group.stratifier.stratum.measureScore.extension:alternateScoreType
                                Slice NamealternateScoreType
                                Definition

                                Possible value types for the measureScore elements in addition to the standard Quantity type. The alternate type is determined by the Quality Measure Aggregate Method extension used on the Measure. The reported type of the measureScore for continuous variable measures is determined by the result type of the aggregate method operation.

                                ShortPossible additional measureScore value types
                                Comments

                                This extension corresponds to the additional MeasureScore type added to the R5 version of MeasureReport.

                                Control0..1
                                TypeExtension(DEQM Alternate Score Type Extension) (Extension Type: Choice of: dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio)
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                224. MeasureReport.group.stratifier.stratum.measureScore.value
                                Definition

                                The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                ShortNumerical value (with implicit precision)
                                Comments

                                The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                Control0..1
                                Typedecimal
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Precision is handled implicitly in almost all cases of measurement.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                226. MeasureReport.group.stratifier.stratum.measureScore.comparator
                                Definition

                                How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                                Short< | <= | >= | > - how to understand the value
                                Control0..1
                                BindingThe codes SHALL be taken from QuantityComparator
                                (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                How the Quantity should be understood and represented.

                                Typecode
                                Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                Meaning if MissingIf there is no comparator, then there is no modification of the value
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                228. MeasureReport.group.stratifier.stratum.measureScore.unit
                                Definition

                                A human-readable form of the unit.

                                ShortUnit representation
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                230. MeasureReport.group.stratifier.stratum.measureScore.system
                                Definition

                                The identification of the system that provides the coded form of the unit.

                                ShortSystem that defines coded unit form
                                Control0..1
                                This element is affected by the following invariants: qty-3
                                Typeuri
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Need to know the system that defines the coded form of the unit.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                232. MeasureReport.group.stratifier.stratum.measureScore.code
                                Definition

                                A computer processable form of the unit in some unit representation system.

                                ShortCoded form of the unit
                                Comments

                                The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                Control0..1
                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                234. MeasureReport.evaluatedResource
                                Definition

                                A reference to a Bundle containing the Resources that were used in the calculation of this measure.

                                ShortWhat data was used to calculate the measure score
                                Control0..0
                                TypeReference(Resource)
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))