The Measure resource provides the definition of a quality measure.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

An Extension

R5: Measure.versionAlgorithm[x] (new:Coding, string)

Element Measure.versionAlgorithm[x] has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.versionAlgorithm[x] has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). An externally-defined extension that has been mapped as the representation of FHIR R5 element Measure.versionAlgorithm[x]: http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm. If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.

R5: Measure.subtitle (new:string)

Element Measure.subtitle has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.subtitle has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R5: Measure.subject[x] (new:CodeableConcept, Reference(Group))

Element Measure.subject[x] has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.subject[x] has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The subject of the measure is critical in interpreting the criteria definitions, as the logic in the measures is evaluated with respect to a particular subject. This corresponds roughly to the notion of a Compartment in that it limits what content is available based on its relationship to the subject. In CQL, this corresponds to the context declaration.

R5: Measure.basis (new:code)

Element Measure.basis has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.basis has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). For a subject-based measure, the population basis is simply boolean; all the criteria are expressed as true/false conditions that determine membership of an individual case in the population. For non-subject-based measures, the population basis can be any resource type, and the criteria are queries that return the subject's contribution to the population as a list of that resource type. For example, for a procedure-based measure, the population criteria would return lists of procedures that should be included in each population.

R5: Measure.copyrightLabel (new:string)

Element Measure.copyrightLabel has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.copyrightLabel has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). An externally-defined extension that has been mapped as the representation of FHIR R5 element Measure.copyrightLabel: http://hl7.org/fhir/StructureDefinition/artifact-copyrightLabel. The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

R5: Measure.scoringUnit (new:CodeableConcept)

Element Measure.scoringUnit has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.scoringUnit has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). When this element is specified, implementations are expected to report measure scores in the specified units. Note that this may involve unit conversion if the expected units are different than the units of the resulting score calculation. In this case, unit conversions SHALL be performed according to the unit conversion semantics specified by UCUM.

R5: Measure.term (new:BackboneElement)

Element Measure.term has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.term has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

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

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

The status of this measure. Enables tracking the life-cycle of the content.

Allows filtering of measures that are appropriate for use vs. not.
This is labeled as "Is Modifier" because applications should not use a retired measure without due consideration.

The lifecycle status of a Value Set or Concept Map.

A boolean value to indicate that this measure is authored for testing purposes (or education/evaluation/marketing), and is not intended to be used for genuine usage.

Allows filtering of measure that are appropriate for use vs. not. This is labeled as "Is Modifier" because applications should not use an experimental measure in production.

Enables experimental content to be developed following the same lifecycle that would be used for a production-level measure.

R5: Measure.versionAlgorithm[x] (new:Coding, string)

Element Measure.versionAlgorithm[x] has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.versionAlgorithm[x] has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). An externally-defined extension that has been mapped as the representation of FHIR R5 element Measure.versionAlgorithm[x]: http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm. If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.

R5: Measure.subtitle (new:string)

Element Measure.subtitle has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.subtitle has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R5: Measure.subject[x] (new:CodeableConcept, Reference(Group))

Element Measure.subject[x] has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.subject[x] has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The subject of the measure is critical in interpreting the criteria definitions, as the logic in the measures is evaluated with respect to a particular subject. This corresponds roughly to the notion of a Compartment in that it limits what content is available based on its relationship to the subject. In CQL, this corresponds to the context declaration.

R5: Measure.basis (new:code)

Element Measure.basis has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.basis has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). For a subject-based measure, the population basis is simply boolean; all the criteria are expressed as true/false conditions that determine membership of an individual case in the population. For non-subject-based measures, the population basis can be any resource type, and the criteria are queries that return the subject's contribution to the population as a list of that resource type. For example, for a procedure-based measure, the population criteria would return lists of procedures that should be included in each population.

R5: Measure.copyrightLabel (new:string)

Element Measure.copyrightLabel has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.copyrightLabel has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). An externally-defined extension that has been mapped as the representation of FHIR R5 element Measure.copyrightLabel: http://hl7.org/fhir/StructureDefinition/artifact-copyrightLabel. The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

R5: Measure.scoringUnit (new:CodeableConcept)

Element Measure.scoringUnit has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.scoringUnit has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). When this element is specified, implementations are expected to report measure scores in the specified units. Note that this may involve unit conversion if the expected units are different than the units of the resulting score calculation. In this case, unit conversions SHALL be performed according to the unit conversion semantics specified by UCUM.

R5: Measure.term (new:BackboneElement)

Element Measure.term has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.term has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R5: Measure.author additional types (ContactDetail) additional types from child elements (name, telecom)

Element Measure.author is mapped to FHIR STU3 element Measure.contributor as SourceIsBroaderThanTarget. The mappings for Measure.author do not cover the following types: ContactDetail. The mappings for Measure.author do not cover the following types based on type expansion: name, telecom.

R5: Measure.editor additional types (ContactDetail) additional types from child elements (name, telecom)

Element Measure.editor is mapped to FHIR STU3 element Measure.contributor as SourceIsBroaderThanTarget. The mappings for Measure.editor do not cover the following types: ContactDetail. The mappings for Measure.editor do not cover the following types based on type expansion: name, telecom.

R5: Measure.reviewer additional types (ContactDetail) additional types from child elements (name, telecom)

Element Measure.reviewer is mapped to FHIR STU3 element Measure.contributor as SourceIsBroaderThanTarget. The mappings for Measure.reviewer do not cover the following types: ContactDetail. The mappings for Measure.reviewer do not cover the following types based on type expansion: name, telecom. See guidance around (not) making local changes to elements here.

R5: Measure.endorser additional types (ContactDetail) additional types from child elements (name, telecom)

Element Measure.endorser is mapped to FHIR STU3 element Measure.contributor as SourceIsBroaderThanTarget. The mappings for Measure.endorser do not cover the following types: ContactDetail. The mappings for Measure.endorser do not cover the following types based on type expansion: name, telecom. See guidance around (not) making local changes to elements here.

R5: Measure.contact additional types (ContactDetail) additional types from child elements (name, telecom)

Element Measure.contact is mapped to FHIR STU3 element Measure.contact as SourceIsBroaderThanTarget. The mappings for Measure.contact do not cover the following types: ContactDetail. The mappings for Measure.contact do not cover the following types based on type expansion: name, telecom. May be a web site, an email address, a telephone number, etc.

See guidance around (not) making local changes to elements here.

R5: Measure.library additional types (canonical(http://hl7.org/fhir/StructureDefinition/Library)) additional types from child elements (value)

Element Measure.library is mapped to FHIR STU3 element Measure.library as SourceIsBroaderThanTarget. The mappings for Measure.library do not cover the following types: canonical. The mappings for Measure.library do not cover the following types based on type expansion: value.

R5: Measure.improvementNotation additional types (CodeableConcept) additional types from child elements (coding)

Element Measure.improvementNotation is mapped to FHIR STU3 element Measure.improvementNotation as SourceIsBroaderThanTarget. The mappings for Measure.improvementNotation do not cover the following types: CodeableConcept. The mappings for Measure.improvementNotation do not cover the following types based on type expansion: coding.

R5: Measure.group.linkId (new:string)

Element Measure.group.linkId has a context of Measure.group based on following the parent source element upwards and mapping to Measure. Element Measure.group.linkId has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.

LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such

R5: Measure.group.type (new:CodeableConcept)

Element Measure.group.type has a context of Measure.group based on following the parent source element upwards and mapping to Measure. Element Measure.group.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). When specified at the group level, defines the measure type for this specific group. If not specified, the measureType of the group is determined by the root type element

R5: Measure.group.subject[x] (new:CodeableConcept, Reference(Group))

Element Measure.group.subject[x] has a context of Measure.group based on following the parent source element upwards and mapping to Measure. Element Measure.group.subject[x] has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The subject of the measure is critical in interpreting the criteria definitions, as the logic in the measures is evaluated with respect to a particular subject. This corresponds roughly to the notion of a Compartment in that it limits what content is available based on its relationship to the subject. In CQL, this corresponds to the context declaration.

R5: Measure.group.basis (new:code)

Element Measure.group.basis has a context of Measure.group based on following the parent source element upwards and mapping to Measure. Element Measure.group.basis has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). When specified at the group level, defines the population basis for this specific group. If not specified, the basis for the group is determined by the root basis element

R5: Measure.group.scoring (new:CodeableConcept)

Element Measure.group.scoring has a context of Measure.group based on following the parent source element upwards and mapping to Measure. Element Measure.group.scoring has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). When specified at the group level, defines the scoring for this specific group. If not specified, scoring for this group is determined by the root scoring element

R5: Measure.group.scoringUnit (new:CodeableConcept)

Element Measure.group.scoringUnit has a context of Measure.group based on following the parent source element upwards and mapping to Measure. Element Measure.group.scoringUnit has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). When specified at the group level, this defines the scoringUnit for this specific group. If not specified, the scoringUnit for this group is determined by the root scoringUnit element. As with the root element, when this element is specified, implementations are expected to report measure scores in the specified units. Note that this may involve unit conversion if the expected units are different than the units of the resulting score calculation. In this case, unit conversions SHALL be performed according to the unit conversion semantics specified by UCUM.

R5: Measure.group.rateAggregation (new:markdown)

Element Measure.group.rateAggregation has a context of Measure.group based on following the parent source element upwards and mapping to Measure. Element Measure.group.rateAggregation has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The measure rate for an organization or clinician is based upon the entities’ aggregate data and summarizes the performance of the entity over a given time period (e.g., monthly, quarterly, yearly). The aggregated data are derived from the results of a specific measure algorithm and, if appropriate, the application of specific risk adjustment models. Can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure (e.g., pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two). This could be applied to aggregated cohort measure definitions (e.g., CDC's aggregate reporting for TB at the state level).

R5: Measure.group.improvementNotation (new:CodeableConcept)

Element Measure.group.improvementNotation has a context of Measure.group based on following the parent source element upwards and mapping to Measure. Element Measure.group.improvementNotation has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). When specified at the group level, this element defines the improvementNotation for this specific group. If not specified, improvementNotation for this group is determined by the root improvementNotation element

R5: Measure.group.library (new:canonical(Library))

Element Measure.group.library has a context of Measure.group based on following the parent source element upwards and mapping to Measure. Element Measure.group.library has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R5: Measure.group.code additional types (CodeableConcept) additional types from child elements (coding, text)

Element Measure.group.code is mapped to FHIR STU3 element Measure.group.identifier as SourceIsBroaderThanTarget. The mappings for Measure.group.code do not cover the following types: CodeableConcept. The mappings for Measure.group.code do not cover the following types based on type expansion: coding, text.

R5: Measure.group.population.linkId (new:string)

Element Measure.group.population.linkId has a context of Measure.group.population based on following the parent source element upwards and mapping to Measure. Element Measure.group.population.linkId has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.

LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such

R5: Measure.group.population.groupDefinition (new:Reference(Group))

Element Measure.group.population.groupDefinition has a context of Measure.group.population based on following the parent source element upwards and mapping to Measure. Element Measure.group.population.groupDefinition has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Note that this approach can only be used for measures where the basis is of the same type as the populations (e.g. a Patient-based measure, rather than an Encounter-based measure). In addition, the referenced Group resource SHALL be a definitional (as opposed to an actual) group.

R5: Measure.group.population.inputPopulationId (new:string)

Element Measure.group.population.inputPopulationId has a context of Measure.group.population based on following the parent source element upwards and mapping to Measure. Element Measure.group.population.inputPopulationId has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R5: Measure.group.population.aggregateMethod (new:CodeableConcept)

Element Measure.group.population.aggregateMethod has a context of Measure.group.population based on following the parent source element upwards and mapping to Measure. Element Measure.group.population.aggregateMethod has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R5: Measure.group.stratifier.linkId (new:string)

Element Measure.group.stratifier.linkId has a context of Measure.group.stratifier based on following the parent source element upwards and mapping to Measure. Element Measure.group.stratifier.linkId has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.

LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such

R5: Measure.group.stratifier.description (new:markdown)

Element Measure.group.stratifier.description has a context of Measure.group.stratifier based on following the parent source element upwards and mapping to Measure. Element Measure.group.stratifier.description has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R5: Measure.group.stratifier.groupDefinition (new:Reference(Group))

Element Measure.group.stratifier.groupDefinition has a context of Measure.group.stratifier based on following the parent source element upwards and mapping to Measure. Element Measure.group.stratifier.groupDefinition has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Note that this approach can only be used for measures where the basis is of the same type as the populations (e.g. a Patient-based measure, rather than an Encounter-based measure). In addition, the referenced Group SHALL be a definitional (as opposed to an actual) group.

R5: Measure.group.stratifier.component (new:BackboneElement)

Element Measure.group.stratifier.component has a context of Measure.group.stratifier based on following the parent source element upwards and mapping to Measure. Element Measure.group.stratifier.component has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Stratifiers are defined either as a single criteria, or as a set of component criteria.

R5: Measure.group.stratifier.code additional types (CodeableConcept) additional types from child elements (coding, text)

Element Measure.group.stratifier.code is mapped to FHIR STU3 element Measure.group.stratifier.identifier as SourceIsBroaderThanTarget. The mappings for Measure.group.stratifier.code do not cover the following types: CodeableConcept. The mappings for Measure.group.stratifier.code do not cover the following types based on type expansion: coding, text.

R5: Measure.supplementalData.linkId (new:string)

Element Measure.supplementalData.linkId has a context of Measure.supplementalData based on following the parent source element upwards and mapping to Measure. Element Measure.supplementalData.linkId has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.

LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such

R5: Measure.supplementalData.description (new:markdown)

Element Measure.supplementalData.description has a context of Measure.supplementalData based on following the parent source element upwards and mapping to Measure. Element Measure.supplementalData.description has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R5: Measure.supplementalData.code additional types (CodeableConcept) additional types from child elements (coding, text)

Element Measure.supplementalData.code is mapped to FHIR STU3 element Measure.supplementalData.identifier as SourceIsBroaderThanTarget. The mappings for Measure.supplementalData.code do not cover the following types: CodeableConcept. The mappings for Measure.supplementalData.code do not cover the following types based on type expansion: coding, text.

The Measure resource provides the definition of a quality measure.

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

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

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

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

The base language in which the resource is written.

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

Unless not suitable, these codes SHALL be taken from Common Languages
(extensible to http://hl7.org/fhir/ValueSet/languages|3.0.2)

A human language.

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

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

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

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

An Extension

R5: Measure.versionAlgorithm[x] (new:Coding, string)

Element Measure.versionAlgorithm[x] has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.versionAlgorithm[x] has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). An externally-defined extension that has been mapped as the representation of FHIR R5 element Measure.versionAlgorithm[x]: http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm. If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.

R5: Measure.subtitle (new:string)

Element Measure.subtitle has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.subtitle has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R5: Measure.subject[x] (new:CodeableConcept, Reference(Group))

Element Measure.subject[x] has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.subject[x] has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The subject of the measure is critical in interpreting the criteria definitions, as the logic in the measures is evaluated with respect to a particular subject. This corresponds roughly to the notion of a Compartment in that it limits what content is available based on its relationship to the subject. In CQL, this corresponds to the context declaration.

R5: Measure.basis (new:code)

Element Measure.basis has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.basis has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). For a subject-based measure, the population basis is simply boolean; all the criteria are expressed as true/false conditions that determine membership of an individual case in the population. For non-subject-based measures, the population basis can be any resource type, and the criteria are queries that return the subject's contribution to the population as a list of that resource type. For example, for a procedure-based measure, the population criteria would return lists of procedures that should be included in each population.

R5: Measure.copyrightLabel (new:string)

Element Measure.copyrightLabel has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.copyrightLabel has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). An externally-defined extension that has been mapped as the representation of FHIR R5 element Measure.copyrightLabel: http://hl7.org/fhir/StructureDefinition/artifact-copyrightLabel. The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

R5: Measure.scoringUnit (new:CodeableConcept)

Element Measure.scoringUnit has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.scoringUnit has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). When this element is specified, implementations are expected to report measure scores in the specified units. Note that this may involve unit conversion if the expected units are different than the units of the resulting score calculation. In this case, unit conversions SHALL be performed according to the unit conversion semantics specified by UCUM.

R5: Measure.term (new:BackboneElement)

Element Measure.term has a context of Measure based on following the parent source element upwards and mapping to Measure. Element Measure.term has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

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

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

An absolute URI that is used to identify this measure when it is referenced in a specification, model, design or an instance. This SHALL be a URL, SHOULD be globally unique, and SHOULD be an address at which this measure is (or will be) published. The URL SHOULD include the major version of the measure. For more information see Technical and Business Versions.

Can be a urn:uuid: or a urn:oid:, but real http: addresses are preferred. Multiple instances may share the same url if they have a distinct version.

Allows the measure to be referenced by a single globally unique identifier.

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

Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, e.g., to identify this measure outside of FHIR, where it is not possible to use the logical URI.

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

The identifier that is used to identify this version of the measure when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the measure author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifacts.

There may be different measure instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a refrence to a particular business version of the measure with the format [url]|[version].

A natural language name identifying the measure. This name should be usable as an identifier for the module by machine processing applications such as code generation.

The name is not expected to be globally unique. The name should be a simple alpha-numeric type name to ensure that it is computable friendly.

Support human navigation and code generation.

A short, descriptive, user-friendly title for the measure.

This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

The status of this measure. Enables tracking the life-cycle of the content.

Allows filtering of measures that are appropriate for use vs. not.
This is labeled as "Is Modifier" because applications should not use a retired measure without due consideration.

The lifecycle status of a Value Set or Concept Map.

A boolean value to indicate that this measure is authored for testing purposes (or education/evaluation/marketing), and is not intended to be used for genuine usage.

Allows filtering of measure that are appropriate for use vs. not. This is labeled as "Is Modifier" because applications should not use an experimental measure in production.

Enables experimental content to be developed following the same lifecycle that would be used for a production-level measure.

The date (and optionally time) when the measure was published. The date must change if and when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the measure changes.

Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the measure. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

The name of the individual or organization that published the measure.

Usually an organization, but may be an individual. The publisher (or steward) of the measure is the organization or individual primarily responsible for the maintenance and upkeep of the measure. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the measure. This item SHOULD be populated unless the information is available from context.

Helps establish the "authority/credibility" of the measure. May also allow for contact.

A free text natural language description of the measure from a consumer's perspective.

This description can be used to capture details such as why the measure was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the measure as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the profile is presumed to be the predominant language in the place the profile was created).

Explaination of why this measure is needed and why it has been designed as it has.

This element does not describe the usage of the measure Instead it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this measure.

A detailed description of how the measure is used from a clinical perspective.

The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

The 'date' element may be more recent than the approval date because of minor changes / editorial corrections.

The date on which the resource content was last reviewed. Review happens periodically after approval, but doesn't change the original approval date.

If specified, this is usually after the approval date.

Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

The period during which the measure content was or is planned to be in active use.

The effective period for a measure determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.

Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of a the measure are or are expected to be used instead.

The content was developed with a focus and intent of supporting the contexts that are listed. These terms may be used to assist with indexing and searching for appropriate measure instances.

When multiple useContexts are specified, there is no expectation whether all or any of the contexts apply.

Assist in searching for appropriate content.

A legal or geographic region in which the measure is intended to be used.

It may be possible for the measure to be used in jurisdictions other than those for which it was originally designed or intended.

Countries and regions within which this artifact is targeted for use

Descriptive topics related to the content of the measure. Topics provide a high-level categorization of the type of the measure that can be useful for filtering and searching.

High-level categorization of the definition, used for searching, sorting, and filtering

Repositories must be able to determine how to categorize the measure so that it can be found by topical searches.

A contributor to the content of the measure, including authors, editors, reviewers, and endorsers.

Consumers of the content must be able to quickly determine who contributed to the content of the measure.

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

An Extension

R5: Measure.author additional types (ContactDetail) additional types from child elements (name, telecom)

Element Measure.author is mapped to FHIR STU3 element Measure.contributor as SourceIsBroaderThanTarget. The mappings for Measure.author do not cover the following types: ContactDetail. The mappings for Measure.author do not cover the following types based on type expansion: name, telecom.

R5: Measure.editor additional types (ContactDetail) additional types from child elements (name, telecom)

Element Measure.editor is mapped to FHIR STU3 element Measure.contributor as SourceIsBroaderThanTarget. The mappings for Measure.editor do not cover the following types: ContactDetail. The mappings for Measure.editor do not cover the following types based on type expansion: name, telecom.

R5: Measure.reviewer additional types (ContactDetail) additional types from child elements (name, telecom)

Element Measure.reviewer is mapped to FHIR STU3 element Measure.contributor as SourceIsBroaderThanTarget. The mappings for Measure.reviewer do not cover the following types: ContactDetail. The mappings for Measure.reviewer do not cover the following types based on type expansion: name, telecom. See guidance around (not) making local changes to elements here.

R5: Measure.endorser additional types (ContactDetail) additional types from child elements (name, telecom)

Element Measure.endorser is mapped to FHIR STU3 element Measure.contributor as SourceIsBroaderThanTarget. The mappings for Measure.endorser do not cover the following types: ContactDetail. The mappings for Measure.endorser do not cover the following types based on type expansion: name, telecom. See guidance around (not) making local changes to elements here.

The type of contributor.

The type of contributor

The name of the individual or organization responsible for the contribution.

Contact details to assist a user in finding and communicating with the contributor.

Contact details to assist a user in finding and communicating with the publisher.

May be a web site, an email address, a telephone number, etc.

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

An Extension

R5: Measure.contact additional types (ContactDetail) additional types from child elements (name, telecom)

Element Measure.contact is mapped to FHIR STU3 element Measure.contact as SourceIsBroaderThanTarget. The mappings for Measure.contact do not cover the following types: ContactDetail. The mappings for Measure.contact do not cover the following types based on type expansion: name, telecom. May be a web site, an email address, a telephone number, etc.

See guidance around (not) making local changes to elements here.

The name of an individual to contact.

If there is no named individual, the telecom information is for the organization as a whole.

The contact details for the individual (if a name was provided) or the organization.

A copyright statement relating to the measure and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the measure.

Consumers must be able to determine any legal restrictions on the use of the measure and/or its content.

Related artifacts such as additional documentation, justification, or bibliographic references.

Each related artifact is either an attachment, or a reference to another resource, but not both.

Measures must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.

A reference to a Library resource containing the formal logic used by the measure.

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

An Extension

R5: Measure.library additional types (canonical(http://hl7.org/fhir/StructureDefinition/Library)) additional types from child elements (value)

Element Measure.library is mapped to FHIR STU3 element Measure.library as SourceIsBroaderThanTarget. The mappings for Measure.library do not cover the following types: canonical. The mappings for Measure.library do not cover the following types based on type expansion: value.

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

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

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

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

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

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

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

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

Notices and disclaimers regarding the use of the measure, or related to intellectual property (such as code systems) referenced by the measure.

Some organizations require that notices and disclosures be included when publishing measures that reference their intellecutal property.

Indicates how the calculation is performed for the measure, including proportion, ratio, continuous variable, and cohort. The value set is extensible, allowing additional measure scoring types to be represented.

The scoring type of the measure

If this is a composite measure, the scoring method used to combine the component measures to determine the composite score.

The composite scoring method of the measure

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.

The type of measure (includes codes from 2.16.840.1.113883.1.11.20368)

A description of the risk adjustment factors that may impact the resulting score for the measure and how they may be accounted for when computing and reporting measure results.

Describes the method of adjusting for clinical severity and conditions present at the start of care that can influence patient outcomes for making valid comparisons of outcome measures across providers. Indicates whether an eMeasure is subject to the statistical process for reducing, removing, or clarifying the influences of confounding factors to allow more useful comparisons.

Describes how to combine the information calculated, based on logic in each of several populations, into one summarized result.

The measure rate for an organization or clinician is based upon the entities’ aggregate data and summarizes the performance of the entity over a given time period (e.g., monthly, quarterly, yearly). The aggregated data are derived from the results of a specific measure algorithm and, if appropriate, the application of specific risk adjustment models. Can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure (e.g., pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two). This could be applied to aggregated cohort measure definitions (e.g., CDC's aggregate reporting for TB at the state level).

Provides a succint statement of the need for the measure. Usually includes statements pertaining to importance criterion: impact, gap in care, and evidence.

Provides a summary of relevant clinical guidelines or other clinical recommendations supporting the measure.

Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is whthin a range).

Measure consumers and implementers must be able to determine how to interpret a measure score.

unique id for the element within a resource (for internal references)

An Extension

R5: Measure.improvementNotation additional types (CodeableConcept) additional types from child elements (coding)

Element Measure.improvementNotation is mapped to FHIR STU3 element Measure.improvementNotation as SourceIsBroaderThanTarget. The mappings for Measure.improvementNotation do not cover the following types: CodeableConcept. The mappings for Measure.improvementNotation do not cover the following types based on type expansion: coding.

The actual value

Provides a description of an individual term used within the measure.

Measure developers must be able to provide precise definitions of terms used within measure descriptions and guidance to help communicate the intent of the measure.

Additional guidance for the measure including how it can be used in a clinical context, and the intent of the measure.

Measure developers must be able to provide additional guidance for implementers to understand the intent with greater specificity than that provided in the logic of the measure.

The measure set, e.g. Preventive Care and Screening.

A group of population criteria for the measure.

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

An Extension

R5: Measure.group.linkId (new:string)

Element Measure.group.linkId has a context of Measure.group based on following the parent source element upwards and mapping to Measure. Element Measure.group.linkId has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.

LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such

R5: Measure.group.type (new:CodeableConcept)

Element Measure.group.type has a context of Measure.group based on following the parent source element upwards and mapping to Measure. Element Measure.group.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). When specified at the group level, defines the measure type for this specific group. If not specified, the measureType of the group is determined by the root type element

R5: Measure.group.subject[x] (new:CodeableConcept, Reference(Group))

Element Measure.group.subject[x] has a context of Measure.group based on following the parent source element upwards and mapping to Measure. Element Measure.group.subject[x] has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The subject of the measure is critical in interpreting the criteria definitions, as the logic in the measures is evaluated with respect to a particular subject. This corresponds roughly to the notion of a Compartment in that it limits what content is available based on its relationship to the subject. In CQL, this corresponds to the context declaration.

R5: Measure.group.basis (new:code)

Element Measure.group.basis has a context of Measure.group based on following the parent source element upwards and mapping to Measure. Element Measure.group.basis has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). When specified at the group level, defines the population basis for this specific group. If not specified, the basis for the group is determined by the root basis element

R5: Measure.group.scoring (new:CodeableConcept)

Element Measure.group.scoring has a context of Measure.group based on following the parent source element upwards and mapping to Measure. Element Measure.group.scoring has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). When specified at the group level, defines the scoring for this specific group. If not specified, scoring for this group is determined by the root scoring element

R5: Measure.group.scoringUnit (new:CodeableConcept)

Element Measure.group.scoringUnit has a context of Measure.group based on following the parent source element upwards and mapping to Measure. Element Measure.group.scoringUnit has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). When specified at the group level, this defines the scoringUnit for this specific group. If not specified, the scoringUnit for this group is determined by the root scoringUnit element. As with the root element, when this element is specified, implementations are expected to report measure scores in the specified units. Note that this may involve unit conversion if the expected units are different than the units of the resulting score calculation. In this case, unit conversions SHALL be performed according to the unit conversion semantics specified by UCUM.

R5: Measure.group.rateAggregation (new:markdown)

Element Measure.group.rateAggregation has a context of Measure.group based on following the parent source element upwards and mapping to Measure. Element Measure.group.rateAggregation has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The measure rate for an organization or clinician is based upon the entities’ aggregate data and summarizes the performance of the entity over a given time period (e.g., monthly, quarterly, yearly). The aggregated data are derived from the results of a specific measure algorithm and, if appropriate, the application of specific risk adjustment models. Can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure (e.g., pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two). This could be applied to aggregated cohort measure definitions (e.g., CDC's aggregate reporting for TB at the state level).

R5: Measure.group.improvementNotation (new:CodeableConcept)

Element Measure.group.improvementNotation has a context of Measure.group based on following the parent source element upwards and mapping to Measure. Element Measure.group.improvementNotation has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). When specified at the group level, this element defines the improvementNotation for this specific group. If not specified, improvementNotation for this group is determined by the root improvementNotation element

R5: Measure.group.library (new:canonical(Library))

Element Measure.group.library has a context of Measure.group based on following the parent source element upwards and mapping to Measure. Element Measure.group.library has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

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

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

A unique identifier for the group. This identifier will used to report data for the group in the measure report.

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

An Extension

R5: Measure.group.code additional types (CodeableConcept) additional types from child elements (coding, text)

Element Measure.group.code is mapped to FHIR STU3 element Measure.group.identifier as SourceIsBroaderThanTarget. The mappings for Measure.group.code do not cover the following types: CodeableConcept. The mappings for Measure.group.code do not cover the following types based on type expansion: coding, text.

The purpose of this identifier.

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Identifies the purpose for this identifier, if known .

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.

Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Allows users to make use of identifiers when the identifier system is not known.

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.

Time period during which identifier is/was valid for use.

Organization that issued/manages the identifier.

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Optional name or short description of this group.

The human readable description of this population group.

A population criteria for the measure.

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

An Extension

R5: Measure.group.population.linkId (new:string)

Element Measure.group.population.linkId has a context of Measure.group.population based on following the parent source element upwards and mapping to Measure. Element Measure.group.population.linkId has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.

LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such

R5: Measure.group.population.groupDefinition (new:Reference(Group))

Element Measure.group.population.groupDefinition has a context of Measure.group.population based on following the parent source element upwards and mapping to Measure. Element Measure.group.population.groupDefinition has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Note that this approach can only be used for measures where the basis is of the same type as the populations (e.g. a Patient-based measure, rather than an Encounter-based measure). In addition, the referenced Group resource SHALL be a definitional (as opposed to an actual) group.

R5: Measure.group.population.inputPopulationId (new:string)

Element Measure.group.population.inputPopulationId has a context of Measure.group.population based on following the parent source element upwards and mapping to Measure. Element Measure.group.population.inputPopulationId has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R5: Measure.group.population.aggregateMethod (new:CodeableConcept)

Element Measure.group.population.aggregateMethod has a context of Measure.group.population based on following the parent source element upwards and mapping to Measure. Element Measure.group.population.aggregateMethod has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

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

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

A unique identifier for the population criteria. This identifier is used to report data against this criteria within the measure report.

The type of population criteria.

The type of population

Optional name or short description of this population.

The human readable description of this population criteria.

The name of a valid referenced CQL expression (may be namespaced) that defines this population criteria.

In the case of a continuous variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information.

The stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library, or a valid FHIR Resource Path.

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

An Extension

R5: Measure.group.stratifier.linkId (new:string)

Element Measure.group.stratifier.linkId has a context of Measure.group.stratifier based on following the parent source element upwards and mapping to Measure. Element Measure.group.stratifier.linkId has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.

LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such

R5: Measure.group.stratifier.description (new:markdown)

Element Measure.group.stratifier.description has a context of Measure.group.stratifier based on following the parent source element upwards and mapping to Measure. Element Measure.group.stratifier.description has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R5: Measure.group.stratifier.groupDefinition (new:Reference(Group))

Element Measure.group.stratifier.groupDefinition has a context of Measure.group.stratifier based on following the parent source element upwards and mapping to Measure. Element Measure.group.stratifier.groupDefinition has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Note that this approach can only be used for measures where the basis is of the same type as the populations (e.g. a Patient-based measure, rather than an Encounter-based measure). In addition, the referenced Group SHALL be a definitional (as opposed to an actual) group.

R5: Measure.group.stratifier.component (new:BackboneElement)

Element Measure.group.stratifier.component has a context of Measure.group.stratifier based on following the parent source element upwards and mapping to Measure. Element Measure.group.stratifier.component has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Stratifiers are defined either as a single criteria, or as a set of component criteria.

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

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

The identifier for the stratifier used to coordinate the reported data back to this stratifier.

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

An Extension

R5: Measure.group.stratifier.code additional types (CodeableConcept) additional types from child elements (coding, text)

Element Measure.group.stratifier.code is mapped to FHIR STU3 element Measure.group.stratifier.identifier as SourceIsBroaderThanTarget. The mappings for Measure.group.stratifier.code do not cover the following types: CodeableConcept. The mappings for Measure.group.stratifier.code do not cover the following types based on type expansion: coding, text.

The purpose of this identifier.

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Identifies the purpose for this identifier, if known .

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.

Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Allows users to make use of identifiers when the identifier system is not known.

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.

Time period during which identifier is/was valid for use.

Organization that issued/manages the identifier.

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

The criteria for the stratifier. This must be the name of an expression defined within a referenced library.

The path to an element that defines the stratifier, specified as a valid FHIR resource path.

The supplemental data criteria for the measure report, specified as either the name of a valid CQL expression within a referenced library, or a valid FHIR Resource Path.

Note that supplemental data are reported as observations for each patient and included in the evaluatedResources bundle. See the MeasureReport resource or the Quality Reporting topic for more information.

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

An Extension

R5: Measure.supplementalData.linkId (new:string)

Element Measure.supplementalData.linkId has a context of Measure.supplementalData based on following the parent source element upwards and mapping to Measure. Element Measure.supplementalData.linkId has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.

LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such

R5: Measure.supplementalData.description (new:markdown)

Element Measure.supplementalData.description has a context of Measure.supplementalData based on following the parent source element upwards and mapping to Measure. Element Measure.supplementalData.description has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

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

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