Quality Measure Implementation Guide
1.0.0-ballot - ballot International flag

This page is part of the Quality Measure Implementation Guide (v1.0.0-ballot: STU1 (v1.0.0) Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. . For a full list of available versions, see the Directory of published versions

Resource Profile: CQM Composite Measure

Official URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositemeasure Version: 1.0.0
Active as of 2024-12-16 Computable Name: CQMCompositeMeasure

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

Usage:

Formal Views of Profile Content

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

This structure is derived from CQMComputableMeasure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure 0..* CQMComputableMeasure A quality measure definition
... Slices for extension Content/Rules for all slices
.... scoringUnit S 0..1 CodeableConcept What units?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
... Slices for relatedArtifact S 0..* RelatedArtifact Additional documentation, citations, etc.
Slice: Unordered, Open by value:type
.... relatedArtifact:component S 0..* RelatedArtifact Additional documentation, citations, etc.
..... Slices for extension Content/Rules for all slices
...... groupId S 0..1 string What group
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-groupId
...... weight S 0..1 decimal Contribution?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-weight
..... type S 1..1 code Component measure
Fixed Value: composed-of
..... display S 0..1 string Brief description of the related artifact
..... resource S 1..1 canonical(Measure) What resource is being referenced
... scoring S 0..1 CodeableConcept composite
Binding: Measure Scoring (extensible)
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: composite
... group SC 0..* BackboneElement Population criteria group
cmp-10: Composite measures may not specify population criteria
cmp-11: Composite measures must specify composite scoring and at least one component
.... Slices for extension Content/Rules for all slices
..... scoring SC 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring
Binding: Measure Scoring (extensible): How the measure calculation is performed

..... scoringUnit S 0..1 CodeableConcept What units?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
..... compositeScoring S 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring
Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed

..... component SC 0..* (Complex) What artifact
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
...... Slices for extension Content/Rules for all slices
....... groupId S 0..1 string What group
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-groupId
....... weight S 0..1 decimal Contribution?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-weight
.... population SC 0..* BackboneElement Population criteria

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet / CodeURI
Measure.scoringextensiblePattern: composite
http://terminology.hl7.org/ValueSet/measure-scoring
Measure.compositeScoringextensibleCompositeMeasureScoring
http://terminology.hl7.org/ValueSet/composite-measure-scoring

Constraints

IdGradePath(s)DetailsRequirements
cmp-10errorMeasure.groupComposite measures may not specify population criteria
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'composite' implies population.count() = 0
cmp-11errorMeasure.groupComposite measures must specify composite scoring and at least one component
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'composite' implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component').exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure SC 0..* CQMComputableMeasure A quality measure definition
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
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
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
mea-0: Name should be usable as an identifier for the module by machine processing applications such as code generation
mea-1: Stratifier SHALL be either a single criteria or a set of criteria components
cmp-1: Population basis must be specified at the root, or on each group
cmp-2: Scoring must either be specified at the root, or on each group
cmp-3: Scoring unit may only be specified at the root if the scoring is also specified at the root
cmp-4: Improvement notation must be specified for scoring types other than cohort
cmp-5: If type is specified at the root, it may not be specified on any group
cmp-6: If riskAdjustment is specified at the root, it may not be specified on any group
cmp-7: If rateAggregation is specified at the root, it may not be specified on any group
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... Slices for extension Content/Rules for all slices
.... populationBasis SC 0..1 code What type of population
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis
Binding: FHIRAllTypes (required): The type of elements in the population


ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... scoringUnit SC 0..1 CodeableConcept What units?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... effectiveDataRequirements S 0..1 canonical(CRMI Module Definition Library) Effective required data for evaluation
URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... scoringPrecision 0..1 positiveInt Number of decimal places
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... subject[x] S 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
Binding: Subject Type Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
.... subjectCodeableConcept CodeableConcept
.... subjectReference Reference(Group)
... Slices for relatedArtifact S 0..* RelatedArtifact Additional documentation, citations, etc.
Slice: Unordered, Open by value:type
ele-1: All FHIR elements must have a @value or children
.... relatedArtifact:component S 0..* RelatedArtifact Additional documentation, citations, etc.
ele-1: All FHIR elements must have a @value or children
..... Slices for extension Content/Rules for all slices
...... groupId S 0..1 string What group
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-groupId
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... weight S 0..1 decimal Contribution?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-weight
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... type SΣ 1..1 code Component measure
Binding: RelatedArtifactType (required): The type of relationship to the related artifact.


ele-1: All FHIR elements must have a @value or children
Fixed Value: composed-of
..... display SΣ 0..1 string Brief description of the related artifact
ele-1: All FHIR elements must have a @value or children
..... resource SΣ 1..1 canonical(Measure) What resource is being referenced
ele-1: All FHIR elements must have a @value or children
... library S 0..1 canonical(CRMI Computable Library) Logic used by the measure
ele-1: All FHIR elements must have a @value or children
... scoring SΣC 0..1 CodeableConcept composite
Binding: Measure Scoring (extensible)
ele-1: All FHIR elements must have a @value or children
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: composite
... compositeScoring SΣ 0..1 CodeableConcept opportunity | all-or-nothing | linear | weighted
Binding: CompositeMeasureScoring (extensible)
ele-1: All FHIR elements must have a @value or children
... type SΣC 0..* CodeableConcept process | outcome | structure | patient-reported-outcome | composite
Binding: MeasureType (extensible): The type of measure (includes codes from 2.16.840.1.113883.1.11.20368).


ele-1: All FHIR elements must have a @value or children
... improvementNotation SΣC 0..1 CodeableConcept increase | decrease
Binding: MeasureImprovementNotation (required)
ele-1: All FHIR elements must have a @value or children
... group SC 0..* BackboneElement Population criteria group
ele-1: All FHIR elements must have a @value or children
cmp-8: Scoring unit may only be specified at the root if the scoring is also specified at the root
cmp-9: Improvement notation must be specified for scoring types other than cohort
cmp-10: Composite measures may not specify population criteria
cmp-11: Composite measures must specify composite scoring and at least one component
.... Slices for extension Content/Rules for all slices
..... populationBasis SC 0..1 code What type of population
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis
Binding: FHIRAllTypes (required): The type of elements in the population


ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... scoring SC 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring
Binding: Measure Scoring (extensible): How the measure calculation is performed


ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... scoringUnit SC 0..1 CodeableConcept What units?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... scoringPrecision 0..1 positiveInt Number of decimal places
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... compositeScoring S 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring
Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed


ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... component SC 0..* (Complex) What artifact
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... Slices for extension Content/Rules for all slices
....... groupId S 0..1 string What group
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-groupId
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
....... weight S 0..1 decimal Contribution?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-weight
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... url 1..1 uri "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component"
..... type C 0..* CodeableConcept process | outcome | structure | patient-reported-outcome
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type
Binding: MeasureType (extensible): Indicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilization.


ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... riskAdjustment C 0..1 string How risk adjustment is applied for this measure
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... rateAggregation C 0..1 string How is rate aggregation performed for this measure
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... improvementNotation SC 0..1 CodeableConcept increase | decrease
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation
Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure


ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... code S 0..1 CodeableConcept Meaning of the group
ele-1: All FHIR elements must have a @value or children
.... description S 0..1 string Summary description
ele-1: All FHIR elements must have a @value or children
.... population SC 0..* BackboneElement Population criteria
ele-1: All FHIR elements must have a @value or children
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... code S 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible): The type of population.


ele-1: All FHIR elements must have a @value or children
..... description S 0..1 string The human readable description of this population criteria
ele-1: All FHIR elements must have a @value or children
..... criteria 1..1 Expression The criteria that defines this population
ele-1: All FHIR elements must have a @value or children
.... stratifier S 0..* BackboneElement Stratifier criteria for the measure
ele-1: All FHIR elements must have a @value or children
..... Slices for extension Content/Rules for all slices
...... appliesTo 0..* CodeableConcept Which population does this stratifier apply to?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo
Binding: MeasurePopulationType (extensible): Indicates the population


ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... code S 0..1 CodeableConcept Meaning of the stratifier
ele-1: All FHIR elements must have a @value or children
..... description S 0..1 string The human readable description of this stratifier
ele-1: All FHIR elements must have a @value or children
..... component S 0..* BackboneElement Stratifier criteria component for the measure
ele-1: All FHIR elements must have a @value or children
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... code S 0..1 CodeableConcept Meaning of the stratifier component
ele-1: All FHIR elements must have a @value or children
...... description S 0..1 string The human readable description of this stratifier component
ele-1: All FHIR elements must have a @value or children
...... criteria 1..1 Expression Component of how the measure should be stratified
ele-1: All FHIR elements must have a @value or children
... supplementalData S 0..* BackboneElement What other data should be reported with the measure
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... code S 0..1 CodeableConcept Meaning of the supplemental data
ele-1: All FHIR elements must have a @value or children
.... usage S 0..* CodeableConcept supplemental-data | risk-adjustment-factor
Binding: MeasureDataUsage (extensible): The intended usage for supplemental data elements in the measure.


ele-1: All FHIR elements must have a @value or children
.... description S 0..1 string The human readable description of this supplemental data
ele-1: All FHIR elements must have a @value or children
.... criteria 1..1 Expression Expression describing additional data to be reported
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Measure.statusrequiredPublicationStatus
http://hl7.org/fhir/ValueSet/publication-status|4.0.1
from the FHIR Standard
Measure.subject[x]extensibleSubjectTypeValueSet
http://hl7.org/fhir/uv/cqm/ValueSet/subject-type
from this IG
Measure.relatedArtifact:component.typerequiredFixed Value: composed-of
http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1
from the FHIR Standard
Measure.scoringextensiblePattern: composite
http://terminology.hl7.org/ValueSet/measure-scoring
Measure.compositeScoringextensibleCompositeMeasureScoring
http://terminology.hl7.org/ValueSet/composite-measure-scoring
Measure.typeextensibleMeasureType
http://hl7.org/fhir/ValueSet/measure-type
from the FHIR Standard
Measure.improvementNotationrequiredMeasureImprovementNotation
http://terminology.hl7.org/ValueSet/measure-improvement-notation
Measure.group.population.codeextensibleMeasurePopulationType
http://hl7.org/fhir/ValueSet/measure-population
from the FHIR Standard
Measure.supplementalData.usageextensibleMeasureDataUsage
http://hl7.org/fhir/ValueSet/measure-data-usage
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
cmp-1errorMeasurePopulation basis must be specified at the root, or on each group
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists() or group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists()).allTrue()
cmp-2errorMeasureScoring must either be specified at the root, or on each group
: scoring.exists() xor (group.exists() and group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()).allTrue())
cmp-3errorMeasureScoring unit may only be specified at the root if the scoring is also specified at the root
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies scoring.exists()
cmp-4errorMeasureImprovement notation must be specified for scoring types other than cohort
: (scoring.exists() and (scoring.coding.code.contains('proportion') or scoring.coding.code.contains('ratio') or scoring.coding.code.contains('continuous-variable') or scoring.coding.code.contains('composite')) and improvementNotation.exists()) xor (group.exists() and group.select((extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and (extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code.contains('proportion') or extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code.contains('ratio') or extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code.contains('continuous-variable') or extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code.contains('composite')) and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation').exists())).allTrue()) xor (scoring.exists() and scoring.coding.code.contains('cohort'))
cmp-5errorMeasureIf type is specified at the root, it may not be specified on any group
: type.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type').exists()).allFalse()
cmp-6errorMeasureIf riskAdjustment is specified at the root, it may not be specified on any group
: riskAdjustment.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment').exists()).allFalse()
cmp-7errorMeasureIf rateAggregation is specified at the root, it may not be specified on any group
: rateAggregation.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation').exists()).allFalse()
cmp-8errorMeasure.groupScoring unit may only be specified at the root if the scoring is also specified at the root
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()
cmp-9errorMeasure.groupImprovement notation must be specified for scoring types other than cohort
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value in ('proportion' | 'ratio' | 'continuous-variable') implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation').exists()
cmp-10errorMeasure.groupComposite measures may not specify population criteria
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'composite' implies population.count() = 0
cmp-11errorMeasure.groupComposite measures must specify composite scoring and at least one component
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'composite' implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component').exists()
dom-2errorMeasureIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMeasureIf 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-4errorMeasureIf 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-5errorMeasureIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMeasureA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mea-0warningMeasureName should be usable as an identifier for the module by machine processing applications such as code generation
: name.matches('[A-Z]([A-Za-z0-9_]){0,254}')
mea-1errorMeasureStratifier SHALL be either a single criteria or a set of criteria components
: group.stratifier.all((code | description | criteria).exists() xor component.exists())
NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure SC 0..* CQMComputableMeasure A quality measure definition
mea-0: Name should be usable as an identifier for the module by machine processing applications such as code generation
mea-1: Stratifier SHALL be either a single criteria or a set of criteria components
cmp-1: Population basis must be specified at the root, or on each group
cmp-2: Scoring must either be specified at the root, or on each group
cmp-3: Scoring unit may only be specified at the root if the scoring is also specified at the root
cmp-4: Improvement notation must be specified for scoring types other than cohort
cmp-5: If type is specified at the root, it may not be specified on any group
cmp-6: If riskAdjustment is specified at the root, it may not be specified on any group
cmp-7: If rateAggregation is specified at the root, it may not be specified on any group
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... populationBasis SC 0..1 code What type of population
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis
Binding: FHIRAllTypes (required): The type of elements in the population


.... scoringUnit SC 0..1 CodeableConcept What units?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
.... effectiveDataRequirements S 0..1 canonical(CRMI Module Definition Library) Effective required data for evaluation
URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
.... scoringPrecision 0..1 positiveInt Number of decimal places
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... url Σ 0..1 uri Canonical identifier for this measure, represented as a URI (globally unique)
... identifier Σ 0..* Identifier Additional identifier for the measure
... version Σ 0..1 string Business version of the measure
... name ΣC 0..1 string Name for this measure (computer friendly)
... title Σ 0..1 string Name for this measure (human friendly)
... subtitle 0..1 string Subordinate title of the measure
... status ?!Σ 1..1 code draft | active | retired | unknown
Binding: PublicationStatus (required): The lifecycle status of an artifact.

... experimental Σ 0..1 boolean For testing purposes, not real usage
... subject[x] S 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
Binding: Subject Type Value Set (extensible)
.... subjectCodeableConcept CodeableConcept
.... subjectReference Reference(Group)
... date Σ 0..1 dateTime Date last changed
... publisher Σ 0..1 string Name of the publisher (organization or individual)
... contact Σ 0..* ContactDetail Contact details for the publisher
... description Σ 0..1 markdown Natural language description of the measure
... useContext Σ 0..* UsageContext The context that the content is intended to support
... jurisdiction Σ 0..* CodeableConcept Intended jurisdiction for measure (if applicable)
Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.


... purpose 0..1 markdown Why this measure is defined
... usage 0..1 string Describes the clinical usage of the measure
... copyright 0..1 markdown Use and/or publishing restrictions
... approvalDate 0..1 date When the measure was approved by publisher
... lastReviewDate 0..1 date When the measure was last reviewed
... effectivePeriod Σ 0..1 Period When the measure is expected to be used
... topic 0..* CodeableConcept The category of the measure, such as Education, Treatment, Assessment, etc.
Binding: DefinitionTopic (example): High-level categorization of the definition, used for searching, sorting, and filtering.


... author 0..* ContactDetail Who authored the content
... editor 0..* ContactDetail Who edited the content
... reviewer 0..* ContactDetail Who reviewed the content
... endorser 0..* ContactDetail Who endorsed the content
... Slices for relatedArtifact S 0..* RelatedArtifact Additional documentation, citations, etc.
Slice: Unordered, Open by value:type
.... relatedArtifact:component S 0..* RelatedArtifact Additional documentation, citations, etc.
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... groupId S 0..1 string What group
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-groupId
...... weight S 0..1 decimal Contribution?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-weight
..... type SΣ 1..1 code Component measure
Binding: RelatedArtifactType (required): The type of relationship to the related artifact.


Fixed Value: composed-of
..... label Σ 0..1 string Short label
..... display SΣ 0..1 string Brief description of the related artifact
..... citation Σ 0..1 markdown Bibliographic citation for the artifact
..... url Σ 0..1 url Where the artifact can be accessed
..... document Σ 0..1 Attachment What document is being referenced
..... resource SΣ 1..1 canonical(Measure) What resource is being referenced
... library S 0..1 canonical(CRMI Computable Library) Logic used by the measure
... disclaimer Σ 0..1 markdown Disclaimer for use of the measure or its referenced content
... scoring SΣC 0..1 CodeableConcept composite
Binding: Measure Scoring (extensible)
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: composite
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... compositeScoring SΣ 0..1 CodeableConcept opportunity | all-or-nothing | linear | weighted
Binding: CompositeMeasureScoring (extensible)
... type SΣC 0..* CodeableConcept process | outcome | structure | patient-reported-outcome | composite
Binding: MeasureType (extensible): The type of measure (includes codes from 2.16.840.1.113883.1.11.20368).


... riskAdjustment ΣC 0..1 string How risk adjustment is applied for this measure
... rateAggregation ΣC 0..1 string How is rate aggregation performed for this measure
... rationale Σ 0..1 markdown Detailed description of why the measure exists
... clinicalRecommendationStatement Σ 0..1 markdown Summary of clinical guidelines
... improvementNotation SΣC 0..1 CodeableConcept increase | decrease
Binding: MeasureImprovementNotation (required)
... definition Σ 0..* markdown Defined terms used in the measure documentation
... guidance Σ 0..1 markdown Additional guidance for implementers
... group SC 0..* BackboneElement Population criteria group
cmp-8: Scoring unit may only be specified at the root if the scoring is also specified at the root
cmp-9: Improvement notation must be specified for scoring types other than cohort
cmp-10: Composite measures may not specify population criteria
cmp-11: Composite measures must specify composite scoring and at least one component
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... populationBasis SC 0..1 code What type of population
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis
Binding: FHIRAllTypes (required): The type of elements in the population


..... scoring SC 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring
Binding: Measure Scoring (extensible): How the measure calculation is performed


..... scoringUnit SC 0..1 CodeableConcept What units?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
..... scoringPrecision 0..1 positiveInt Number of decimal places
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
..... compositeScoring S 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring
Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed


..... component SC 0..* (Complex) What artifact
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
...... id 0..1 string Unique id for inter-element referencing
...... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... groupId S 0..1 string What group
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-groupId
....... weight S 0..1 decimal Contribution?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-weight
...... url 1..1 uri "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component"
...... value[x] 0..1 RelatedArtifact Value of extension
..... type C 0..* CodeableConcept process | outcome | structure | patient-reported-outcome
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type
Binding: MeasureType (extensible): Indicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilization.


..... riskAdjustment C 0..1 string How risk adjustment is applied for this measure
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
..... rateAggregation C 0..1 string How is rate aggregation performed for this measure
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
..... improvementNotation SC 0..1 CodeableConcept increase | decrease
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation
Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure


.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code S 0..1 CodeableConcept Meaning of the group
.... description S 0..1 string Summary description
.... population SC 0..* BackboneElement Population criteria
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code S 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible): The type of population.

..... description S 0..1 string The human readable description of this population criteria
..... criteria 1..1 Expression The criteria that defines this population
.... stratifier S 0..* BackboneElement Stratifier criteria for the measure
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... appliesTo 0..* CodeableConcept Which population does this stratifier apply to?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo
Binding: MeasurePopulationType (extensible): Indicates the population


..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code S 0..1 CodeableConcept Meaning of the stratifier
..... description S 0..1 string The human readable description of this stratifier
..... criteria 0..1 Expression How the measure should be stratified
..... component S 0..* BackboneElement Stratifier criteria component for the measure
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 0..1 CodeableConcept Meaning of the stratifier component
...... description S 0..1 string The human readable description of this stratifier component
...... criteria 1..1 Expression Component of how the measure should be stratified
... supplementalData S 0..* BackboneElement What other data should be reported with the measure
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code S 0..1 CodeableConcept Meaning of the supplemental data
.... usage S 0..* CodeableConcept supplemental-data | risk-adjustment-factor
Binding: MeasureDataUsage (extensible): The intended usage for supplemental data elements in the measure.


.... description S 0..1 string The human readable description of this supplemental data
.... criteria 1..1 Expression Expression describing additional data to be reported

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Measure.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Measure.statusrequiredPublicationStatus
http://hl7.org/fhir/ValueSet/publication-status|4.0.1
from the FHIR Standard
Measure.subject[x]extensibleSubjectTypeValueSet
http://hl7.org/fhir/uv/cqm/ValueSet/subject-type
from this IG
Measure.jurisdictionextensibleJurisdiction ValueSet
http://hl7.org/fhir/ValueSet/jurisdiction
from the FHIR Standard
Measure.topicexampleDefinitionTopic
http://hl7.org/fhir/ValueSet/definition-topic
from the FHIR Standard
Measure.relatedArtifact:component.typerequiredFixed Value: composed-of
http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1
from the FHIR Standard
Measure.scoringextensiblePattern: composite
http://terminology.hl7.org/ValueSet/measure-scoring
Measure.compositeScoringextensibleCompositeMeasureScoring
http://terminology.hl7.org/ValueSet/composite-measure-scoring
Measure.typeextensibleMeasureType
http://hl7.org/fhir/ValueSet/measure-type
from the FHIR Standard
Measure.improvementNotationrequiredMeasureImprovementNotation
http://terminology.hl7.org/ValueSet/measure-improvement-notation
Measure.group.population.codeextensibleMeasurePopulationType
http://hl7.org/fhir/ValueSet/measure-population
from the FHIR Standard
Measure.supplementalData.usageextensibleMeasureDataUsage
http://hl7.org/fhir/ValueSet/measure-data-usage
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
cmp-1errorMeasurePopulation basis must be specified at the root, or on each group
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists() or group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists()).allTrue()
cmp-2errorMeasureScoring must either be specified at the root, or on each group
: scoring.exists() xor (group.exists() and group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()).allTrue())
cmp-3errorMeasureScoring unit may only be specified at the root if the scoring is also specified at the root
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies scoring.exists()
cmp-4errorMeasureImprovement notation must be specified for scoring types other than cohort
: (scoring.exists() and (scoring.coding.code.contains('proportion') or scoring.coding.code.contains('ratio') or scoring.coding.code.contains('continuous-variable') or scoring.coding.code.contains('composite')) and improvementNotation.exists()) xor (group.exists() and group.select((extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and (extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code.contains('proportion') or extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code.contains('ratio') or extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code.contains('continuous-variable') or extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code.contains('composite')) and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation').exists())).allTrue()) xor (scoring.exists() and scoring.coding.code.contains('cohort'))
cmp-5errorMeasureIf type is specified at the root, it may not be specified on any group
: type.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type').exists()).allFalse()
cmp-6errorMeasureIf riskAdjustment is specified at the root, it may not be specified on any group
: riskAdjustment.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment').exists()).allFalse()
cmp-7errorMeasureIf rateAggregation is specified at the root, it may not be specified on any group
: rateAggregation.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation').exists()).allFalse()
cmp-8errorMeasure.groupScoring unit may only be specified at the root if the scoring is also specified at the root
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()
cmp-9errorMeasure.groupImprovement notation must be specified for scoring types other than cohort
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value in ('proportion' | 'ratio' | 'continuous-variable') implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation').exists()
cmp-10errorMeasure.groupComposite measures may not specify population criteria
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'composite' implies population.count() = 0
cmp-11errorMeasure.groupComposite measures must specify composite scoring and at least one component
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'composite' implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component').exists()
dom-2errorMeasureIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMeasureIf 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-4errorMeasureIf 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-5errorMeasureIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMeasureA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mea-0warningMeasureName should be usable as an identifier for the module by machine processing applications such as code generation
: name.matches('[A-Z]([A-Za-z0-9_]){0,254}')
mea-1errorMeasureStratifier SHALL be either a single criteria or a set of criteria components
: group.stratifier.all((code | description | criteria).exists() xor component.exists())

This structure is derived from CQMComputableMeasure

Summary

Mandatory: 0 element(2 nested mandatory elements)
Must-Support: 18 elements
Fixed: 1 element

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Measure.relatedArtifact

Differential View

This structure is derived from CQMComputableMeasure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure 0..* CQMComputableMeasure A quality measure definition
... Slices for extension Content/Rules for all slices
.... scoringUnit S 0..1 CodeableConcept What units?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
... Slices for relatedArtifact S 0..* RelatedArtifact Additional documentation, citations, etc.
Slice: Unordered, Open by value:type
.... relatedArtifact:component S 0..* RelatedArtifact Additional documentation, citations, etc.
..... Slices for extension Content/Rules for all slices
...... groupId S 0..1 string What group
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-groupId
...... weight S 0..1 decimal Contribution?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-weight
..... type S 1..1 code Component measure
Fixed Value: composed-of
..... display S 0..1 string Brief description of the related artifact
..... resource S 1..1 canonical(Measure) What resource is being referenced
... scoring S 0..1 CodeableConcept composite
Binding: Measure Scoring (extensible)
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: composite
... group SC 0..* BackboneElement Population criteria group
cmp-10: Composite measures may not specify population criteria
cmp-11: Composite measures must specify composite scoring and at least one component
.... Slices for extension Content/Rules for all slices
..... scoring SC 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring
Binding: Measure Scoring (extensible): How the measure calculation is performed

..... scoringUnit S 0..1 CodeableConcept What units?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
..... compositeScoring S 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring
Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed

..... component SC 0..* (Complex) What artifact
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
...... Slices for extension Content/Rules for all slices
....... groupId S 0..1 string What group
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-groupId
....... weight S 0..1 decimal Contribution?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-weight
.... population SC 0..* BackboneElement Population criteria

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet / CodeURI
Measure.scoringextensiblePattern: composite
http://terminology.hl7.org/ValueSet/measure-scoring
Measure.compositeScoringextensibleCompositeMeasureScoring
http://terminology.hl7.org/ValueSet/composite-measure-scoring

Constraints

IdGradePath(s)DetailsRequirements
cmp-10errorMeasure.groupComposite measures may not specify population criteria
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'composite' implies population.count() = 0
cmp-11errorMeasure.groupComposite measures must specify composite scoring and at least one component
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'composite' implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component').exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure SC 0..* CQMComputableMeasure A quality measure definition
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
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
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
mea-0: Name should be usable as an identifier for the module by machine processing applications such as code generation
mea-1: Stratifier SHALL be either a single criteria or a set of criteria components
cmp-1: Population basis must be specified at the root, or on each group
cmp-2: Scoring must either be specified at the root, or on each group
cmp-3: Scoring unit may only be specified at the root if the scoring is also specified at the root
cmp-4: Improvement notation must be specified for scoring types other than cohort
cmp-5: If type is specified at the root, it may not be specified on any group
cmp-6: If riskAdjustment is specified at the root, it may not be specified on any group
cmp-7: If rateAggregation is specified at the root, it may not be specified on any group
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... Slices for extension Content/Rules for all slices
.... populationBasis SC 0..1 code What type of population
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis
Binding: FHIRAllTypes (required): The type of elements in the population


ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... scoringUnit SC 0..1 CodeableConcept What units?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... effectiveDataRequirements S 0..1 canonical(CRMI Module Definition Library) Effective required data for evaluation
URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... scoringPrecision 0..1 positiveInt Number of decimal places
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... subject[x] S 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
Binding: Subject Type Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
.... subjectCodeableConcept CodeableConcept
.... subjectReference Reference(Group)
... Slices for relatedArtifact S 0..* RelatedArtifact Additional documentation, citations, etc.
Slice: Unordered, Open by value:type
ele-1: All FHIR elements must have a @value or children
.... relatedArtifact:component S 0..* RelatedArtifact Additional documentation, citations, etc.
ele-1: All FHIR elements must have a @value or children
..... Slices for extension Content/Rules for all slices
...... groupId S 0..1 string What group
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-groupId
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... weight S 0..1 decimal Contribution?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-weight
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... type SΣ 1..1 code Component measure
Binding: RelatedArtifactType (required): The type of relationship to the related artifact.


ele-1: All FHIR elements must have a @value or children
Fixed Value: composed-of
..... display SΣ 0..1 string Brief description of the related artifact
ele-1: All FHIR elements must have a @value or children
..... resource SΣ 1..1 canonical(Measure) What resource is being referenced
ele-1: All FHIR elements must have a @value or children
... library S 0..1 canonical(CRMI Computable Library) Logic used by the measure
ele-1: All FHIR elements must have a @value or children
... scoring SΣC 0..1 CodeableConcept composite
Binding: Measure Scoring (extensible)
ele-1: All FHIR elements must have a @value or children
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: composite
... compositeScoring SΣ 0..1 CodeableConcept opportunity | all-or-nothing | linear | weighted
Binding: CompositeMeasureScoring (extensible)
ele-1: All FHIR elements must have a @value or children
... type SΣC 0..* CodeableConcept process | outcome | structure | patient-reported-outcome | composite
Binding: MeasureType (extensible): The type of measure (includes codes from 2.16.840.1.113883.1.11.20368).


ele-1: All FHIR elements must have a @value or children
... improvementNotation SΣC 0..1 CodeableConcept increase | decrease
Binding: MeasureImprovementNotation (required)
ele-1: All FHIR elements must have a @value or children
... group SC 0..* BackboneElement Population criteria group
ele-1: All FHIR elements must have a @value or children
cmp-8: Scoring unit may only be specified at the root if the scoring is also specified at the root
cmp-9: Improvement notation must be specified for scoring types other than cohort
cmp-10: Composite measures may not specify population criteria
cmp-11: Composite measures must specify composite scoring and at least one component
.... Slices for extension Content/Rules for all slices
..... populationBasis SC 0..1 code What type of population
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis
Binding: FHIRAllTypes (required): The type of elements in the population


ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... scoring SC 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring
Binding: Measure Scoring (extensible): How the measure calculation is performed


ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... scoringUnit SC 0..1 CodeableConcept What units?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... scoringPrecision 0..1 positiveInt Number of decimal places
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... compositeScoring S 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring
Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed


ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... component SC 0..* (Complex) What artifact
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... Slices for extension Content/Rules for all slices
....... groupId S 0..1 string What group
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-groupId
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
....... weight S 0..1 decimal Contribution?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-weight
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... url 1..1 uri "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component"
..... type C 0..* CodeableConcept process | outcome | structure | patient-reported-outcome
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type
Binding: MeasureType (extensible): Indicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilization.


ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... riskAdjustment C 0..1 string How risk adjustment is applied for this measure
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... rateAggregation C 0..1 string How is rate aggregation performed for this measure
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... improvementNotation SC 0..1 CodeableConcept increase | decrease
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation
Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure


ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... code S 0..1 CodeableConcept Meaning of the group
ele-1: All FHIR elements must have a @value or children
.... description S 0..1 string Summary description
ele-1: All FHIR elements must have a @value or children
.... population SC 0..* BackboneElement Population criteria
ele-1: All FHIR elements must have a @value or children
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... code S 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible): The type of population.


ele-1: All FHIR elements must have a @value or children
..... description S 0..1 string The human readable description of this population criteria
ele-1: All FHIR elements must have a @value or children
..... criteria 1..1 Expression The criteria that defines this population
ele-1: All FHIR elements must have a @value or children
.... stratifier S 0..* BackboneElement Stratifier criteria for the measure
ele-1: All FHIR elements must have a @value or children
..... Slices for extension Content/Rules for all slices
...... appliesTo 0..* CodeableConcept Which population does this stratifier apply to?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo
Binding: MeasurePopulationType (extensible): Indicates the population


ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... code S 0..1 CodeableConcept Meaning of the stratifier
ele-1: All FHIR elements must have a @value or children
..... description S 0..1 string The human readable description of this stratifier
ele-1: All FHIR elements must have a @value or children
..... component S 0..* BackboneElement Stratifier criteria component for the measure
ele-1: All FHIR elements must have a @value or children
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... code S 0..1 CodeableConcept Meaning of the stratifier component
ele-1: All FHIR elements must have a @value or children
...... description S 0..1 string The human readable description of this stratifier component
ele-1: All FHIR elements must have a @value or children
...... criteria 1..1 Expression Component of how the measure should be stratified
ele-1: All FHIR elements must have a @value or children
... supplementalData S 0..* BackboneElement What other data should be reported with the measure
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... code S 0..1 CodeableConcept Meaning of the supplemental data
ele-1: All FHIR elements must have a @value or children
.... usage S 0..* CodeableConcept supplemental-data | risk-adjustment-factor
Binding: MeasureDataUsage (extensible): The intended usage for supplemental data elements in the measure.


ele-1: All FHIR elements must have a @value or children
.... description S 0..1 string The human readable description of this supplemental data
ele-1: All FHIR elements must have a @value or children
.... criteria 1..1 Expression Expression describing additional data to be reported
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Measure.statusrequiredPublicationStatus
http://hl7.org/fhir/ValueSet/publication-status|4.0.1
from the FHIR Standard
Measure.subject[x]extensibleSubjectTypeValueSet
http://hl7.org/fhir/uv/cqm/ValueSet/subject-type
from this IG
Measure.relatedArtifact:component.typerequiredFixed Value: composed-of
http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1
from the FHIR Standard
Measure.scoringextensiblePattern: composite
http://terminology.hl7.org/ValueSet/measure-scoring
Measure.compositeScoringextensibleCompositeMeasureScoring
http://terminology.hl7.org/ValueSet/composite-measure-scoring
Measure.typeextensibleMeasureType
http://hl7.org/fhir/ValueSet/measure-type
from the FHIR Standard
Measure.improvementNotationrequiredMeasureImprovementNotation
http://terminology.hl7.org/ValueSet/measure-improvement-notation
Measure.group.population.codeextensibleMeasurePopulationType
http://hl7.org/fhir/ValueSet/measure-population
from the FHIR Standard
Measure.supplementalData.usageextensibleMeasureDataUsage
http://hl7.org/fhir/ValueSet/measure-data-usage
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
cmp-1errorMeasurePopulation basis must be specified at the root, or on each group
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists() or group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists()).allTrue()
cmp-2errorMeasureScoring must either be specified at the root, or on each group
: scoring.exists() xor (group.exists() and group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()).allTrue())
cmp-3errorMeasureScoring unit may only be specified at the root if the scoring is also specified at the root
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies scoring.exists()
cmp-4errorMeasureImprovement notation must be specified for scoring types other than cohort
: (scoring.exists() and (scoring.coding.code.contains('proportion') or scoring.coding.code.contains('ratio') or scoring.coding.code.contains('continuous-variable') or scoring.coding.code.contains('composite')) and improvementNotation.exists()) xor (group.exists() and group.select((extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and (extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code.contains('proportion') or extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code.contains('ratio') or extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code.contains('continuous-variable') or extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code.contains('composite')) and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation').exists())).allTrue()) xor (scoring.exists() and scoring.coding.code.contains('cohort'))
cmp-5errorMeasureIf type is specified at the root, it may not be specified on any group
: type.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type').exists()).allFalse()
cmp-6errorMeasureIf riskAdjustment is specified at the root, it may not be specified on any group
: riskAdjustment.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment').exists()).allFalse()
cmp-7errorMeasureIf rateAggregation is specified at the root, it may not be specified on any group
: rateAggregation.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation').exists()).allFalse()
cmp-8errorMeasure.groupScoring unit may only be specified at the root if the scoring is also specified at the root
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()
cmp-9errorMeasure.groupImprovement notation must be specified for scoring types other than cohort
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value in ('proportion' | 'ratio' | 'continuous-variable') implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation').exists()
cmp-10errorMeasure.groupComposite measures may not specify population criteria
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'composite' implies population.count() = 0
cmp-11errorMeasure.groupComposite measures must specify composite scoring and at least one component
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'composite' implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component').exists()
dom-2errorMeasureIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMeasureIf 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-4errorMeasureIf 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-5errorMeasureIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMeasureA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mea-0warningMeasureName should be usable as an identifier for the module by machine processing applications such as code generation
: name.matches('[A-Z]([A-Za-z0-9_]){0,254}')
mea-1errorMeasureStratifier SHALL be either a single criteria or a set of criteria components
: group.stratifier.all((code | description | criteria).exists() xor component.exists())

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure SC 0..* CQMComputableMeasure A quality measure definition
mea-0: Name should be usable as an identifier for the module by machine processing applications such as code generation
mea-1: Stratifier SHALL be either a single criteria or a set of criteria components
cmp-1: Population basis must be specified at the root, or on each group
cmp-2: Scoring must either be specified at the root, or on each group
cmp-3: Scoring unit may only be specified at the root if the scoring is also specified at the root
cmp-4: Improvement notation must be specified for scoring types other than cohort
cmp-5: If type is specified at the root, it may not be specified on any group
cmp-6: If riskAdjustment is specified at the root, it may not be specified on any group
cmp-7: If rateAggregation is specified at the root, it may not be specified on any group
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... populationBasis SC 0..1 code What type of population
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis
Binding: FHIRAllTypes (required): The type of elements in the population


.... scoringUnit SC 0..1 CodeableConcept What units?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
.... effectiveDataRequirements S 0..1 canonical(CRMI Module Definition Library) Effective required data for evaluation
URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
.... scoringPrecision 0..1 positiveInt Number of decimal places
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... url Σ 0..1 uri Canonical identifier for this measure, represented as a URI (globally unique)
... identifier Σ 0..* Identifier Additional identifier for the measure
... version Σ 0..1 string Business version of the measure
... name ΣC 0..1 string Name for this measure (computer friendly)
... title Σ 0..1 string Name for this measure (human friendly)
... subtitle 0..1 string Subordinate title of the measure
... status ?!Σ 1..1 code draft | active | retired | unknown
Binding: PublicationStatus (required): The lifecycle status of an artifact.

... experimental Σ 0..1 boolean For testing purposes, not real usage
... subject[x] S 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
Binding: Subject Type Value Set (extensible)
.... subjectCodeableConcept CodeableConcept
.... subjectReference Reference(Group)
... date Σ 0..1 dateTime Date last changed
... publisher Σ 0..1 string Name of the publisher (organization or individual)
... contact Σ 0..* ContactDetail Contact details for the publisher
... description Σ 0..1 markdown Natural language description of the measure
... useContext Σ 0..* UsageContext The context that the content is intended to support
... jurisdiction Σ 0..* CodeableConcept Intended jurisdiction for measure (if applicable)
Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.


... purpose 0..1 markdown Why this measure is defined
... usage 0..1 string Describes the clinical usage of the measure
... copyright 0..1 markdown Use and/or publishing restrictions
... approvalDate 0..1 date When the measure was approved by publisher
... lastReviewDate 0..1 date When the measure was last reviewed
... effectivePeriod Σ 0..1 Period When the measure is expected to be used
... topic 0..* CodeableConcept The category of the measure, such as Education, Treatment, Assessment, etc.
Binding: DefinitionTopic (example): High-level categorization of the definition, used for searching, sorting, and filtering.


... author 0..* ContactDetail Who authored the content
... editor 0..* ContactDetail Who edited the content
... reviewer 0..* ContactDetail Who reviewed the content
... endorser 0..* ContactDetail Who endorsed the content
... Slices for relatedArtifact S 0..* RelatedArtifact Additional documentation, citations, etc.
Slice: Unordered, Open by value:type
.... relatedArtifact:component S 0..* RelatedArtifact Additional documentation, citations, etc.
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... groupId S 0..1 string What group
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-groupId
...... weight S 0..1 decimal Contribution?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-weight
..... type SΣ 1..1 code Component measure
Binding: RelatedArtifactType (required): The type of relationship to the related artifact.


Fixed Value: composed-of
..... label Σ 0..1 string Short label
..... display SΣ 0..1 string Brief description of the related artifact
..... citation Σ 0..1 markdown Bibliographic citation for the artifact
..... url Σ 0..1 url Where the artifact can be accessed
..... document Σ 0..1 Attachment What document is being referenced
..... resource SΣ 1..1 canonical(Measure) What resource is being referenced
... library S 0..1 canonical(CRMI Computable Library) Logic used by the measure
... disclaimer Σ 0..1 markdown Disclaimer for use of the measure or its referenced content
... scoring SΣC 0..1 CodeableConcept composite
Binding: Measure Scoring (extensible)
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: composite
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... compositeScoring SΣ 0..1 CodeableConcept opportunity | all-or-nothing | linear | weighted
Binding: CompositeMeasureScoring (extensible)
... type SΣC 0..* CodeableConcept process | outcome | structure | patient-reported-outcome | composite
Binding: MeasureType (extensible): The type of measure (includes codes from 2.16.840.1.113883.1.11.20368).


... riskAdjustment ΣC 0..1 string How risk adjustment is applied for this measure
... rateAggregation ΣC 0..1 string How is rate aggregation performed for this measure
... rationale Σ 0..1 markdown Detailed description of why the measure exists
... clinicalRecommendationStatement Σ 0..1 markdown Summary of clinical guidelines
... improvementNotation SΣC 0..1 CodeableConcept increase | decrease
Binding: MeasureImprovementNotation (required)
... definition Σ 0..* markdown Defined terms used in the measure documentation
... guidance Σ 0..1 markdown Additional guidance for implementers
... group SC 0..* BackboneElement Population criteria group
cmp-8: Scoring unit may only be specified at the root if the scoring is also specified at the root
cmp-9: Improvement notation must be specified for scoring types other than cohort
cmp-10: Composite measures may not specify population criteria
cmp-11: Composite measures must specify composite scoring and at least one component
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... populationBasis SC 0..1 code What type of population
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis
Binding: FHIRAllTypes (required): The type of elements in the population


..... scoring SC 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring
Binding: Measure Scoring (extensible): How the measure calculation is performed


..... scoringUnit SC 0..1 CodeableConcept What units?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
..... scoringPrecision 0..1 positiveInt Number of decimal places
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
..... compositeScoring S 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring
Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed


..... component SC 0..* (Complex) What artifact
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
...... id 0..1 string Unique id for inter-element referencing
...... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... groupId S 0..1 string What group
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-groupId
....... weight S 0..1 decimal Contribution?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-weight
...... url 1..1 uri "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component"
...... value[x] 0..1 RelatedArtifact Value of extension
..... type C 0..* CodeableConcept process | outcome | structure | patient-reported-outcome
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type
Binding: MeasureType (extensible): Indicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilization.


..... riskAdjustment C 0..1 string How risk adjustment is applied for this measure
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
..... rateAggregation C 0..1 string How is rate aggregation performed for this measure
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
..... improvementNotation SC 0..1 CodeableConcept increase | decrease
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation
Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure


.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code S 0..1 CodeableConcept Meaning of the group
.... description S 0..1 string Summary description
.... population SC 0..* BackboneElement Population criteria
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code S 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible): The type of population.

..... description S 0..1 string The human readable description of this population criteria
..... criteria 1..1 Expression The criteria that defines this population
.... stratifier S 0..* BackboneElement Stratifier criteria for the measure
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... appliesTo 0..* CodeableConcept Which population does this stratifier apply to?
URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo
Binding: MeasurePopulationType (extensible): Indicates the population


..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code S 0..1 CodeableConcept Meaning of the stratifier
..... description S 0..1 string The human readable description of this stratifier
..... criteria 0..1 Expression How the measure should be stratified
..... component S 0..* BackboneElement Stratifier criteria component for the measure
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 0..1 CodeableConcept Meaning of the stratifier component
...... description S 0..1 string The human readable description of this stratifier component
...... criteria 1..1 Expression Component of how the measure should be stratified
... supplementalData S 0..* BackboneElement What other data should be reported with the measure
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code S 0..1 CodeableConcept Meaning of the supplemental data
.... usage S 0..* CodeableConcept supplemental-data | risk-adjustment-factor
Binding: MeasureDataUsage (extensible): The intended usage for supplemental data elements in the measure.


.... description S 0..1 string The human readable description of this supplemental data
.... criteria 1..1 Expression Expression describing additional data to be reported

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Measure.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Measure.statusrequiredPublicationStatus
http://hl7.org/fhir/ValueSet/publication-status|4.0.1
from the FHIR Standard
Measure.subject[x]extensibleSubjectTypeValueSet
http://hl7.org/fhir/uv/cqm/ValueSet/subject-type
from this IG
Measure.jurisdictionextensibleJurisdiction ValueSet
http://hl7.org/fhir/ValueSet/jurisdiction
from the FHIR Standard
Measure.topicexampleDefinitionTopic
http://hl7.org/fhir/ValueSet/definition-topic
from the FHIR Standard
Measure.relatedArtifact:component.typerequiredFixed Value: composed-of
http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1
from the FHIR Standard
Measure.scoringextensiblePattern: composite
http://terminology.hl7.org/ValueSet/measure-scoring
Measure.compositeScoringextensibleCompositeMeasureScoring
http://terminology.hl7.org/ValueSet/composite-measure-scoring
Measure.typeextensibleMeasureType
http://hl7.org/fhir/ValueSet/measure-type
from the FHIR Standard
Measure.improvementNotationrequiredMeasureImprovementNotation
http://terminology.hl7.org/ValueSet/measure-improvement-notation
Measure.group.population.codeextensibleMeasurePopulationType
http://hl7.org/fhir/ValueSet/measure-population
from the FHIR Standard
Measure.supplementalData.usageextensibleMeasureDataUsage
http://hl7.org/fhir/ValueSet/measure-data-usage
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
cmp-1errorMeasurePopulation basis must be specified at the root, or on each group
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists() or group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists()).allTrue()
cmp-2errorMeasureScoring must either be specified at the root, or on each group
: scoring.exists() xor (group.exists() and group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()).allTrue())
cmp-3errorMeasureScoring unit may only be specified at the root if the scoring is also specified at the root
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies scoring.exists()
cmp-4errorMeasureImprovement notation must be specified for scoring types other than cohort
: (scoring.exists() and (scoring.coding.code.contains('proportion') or scoring.coding.code.contains('ratio') or scoring.coding.code.contains('continuous-variable') or scoring.coding.code.contains('composite')) and improvementNotation.exists()) xor (group.exists() and group.select((extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and (extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code.contains('proportion') or extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code.contains('ratio') or extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code.contains('continuous-variable') or extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code.contains('composite')) and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation').exists())).allTrue()) xor (scoring.exists() and scoring.coding.code.contains('cohort'))
cmp-5errorMeasureIf type is specified at the root, it may not be specified on any group
: type.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type').exists()).allFalse()
cmp-6errorMeasureIf riskAdjustment is specified at the root, it may not be specified on any group
: riskAdjustment.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment').exists()).allFalse()
cmp-7errorMeasureIf rateAggregation is specified at the root, it may not be specified on any group
: rateAggregation.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation').exists()).allFalse()
cmp-8errorMeasure.groupScoring unit may only be specified at the root if the scoring is also specified at the root
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()
cmp-9errorMeasure.groupImprovement notation must be specified for scoring types other than cohort
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value in ('proportion' | 'ratio' | 'continuous-variable') implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation').exists()
cmp-10errorMeasure.groupComposite measures may not specify population criteria
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'composite' implies population.count() = 0
cmp-11errorMeasure.groupComposite measures must specify composite scoring and at least one component
: extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'composite' implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component').exists()
dom-2errorMeasureIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMeasureIf 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-4errorMeasureIf 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-5errorMeasureIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMeasureA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mea-0warningMeasureName should be usable as an identifier for the module by machine processing applications such as code generation
: name.matches('[A-Z]([A-Za-z0-9_]){0,254}')
mea-1errorMeasureStratifier SHALL be either a single criteria or a set of criteria components
: group.stratifier.all((code | description | criteria).exists() xor component.exists())

This structure is derived from CQMComputableMeasure

Summary

Mandatory: 0 element(2 nested mandatory elements)
Must-Support: 18 elements
Fixed: 1 element

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Measure.relatedArtifact

 

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