Quality Measure Implementation Guide (STU5)
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This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v5.0.0-ballot: STU5 (v5.0.0) Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 4.0.0. For a full list of available versions, see the Directory of published versions

: Bundle example - JSON Representation

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{
  "resourceType" : "Bundle",
  "id" : "bundle-example",
  "meta" : {
    "source" : "http://example.org/fhir/server"
  },
  "type" : "transaction",
  "entry" : [
    {
      "fullUrl" : "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57904",
      "resource" : {
        "resourceType" : "MeasureReport",
        "id" : "47709cc7-b3ec-4abc-9d26-3df3d3d57904",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/test-case-cqfm"
          ]
        },
        "text" : {
          "status" : "extensions",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MeasureReport</b><a name=\"47709cc7-b3ec-4abc-9d26-3df3d3d57904\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MeasureReport &quot;47709cc7-b3ec-4abc-9d26-3df3d3d57904&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-test-case-cqfm.html\">CQFM Test Case</a></p></div><p><b>CQFM Input Parameters</b>: <a name=\"testcase-example-parameters\"> </a></p><blockquote><p/><p><a name=\"testcase-example-parameters\"> </a></p><h3>Parameters</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Name</b></td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>subject</td><td>123</td></tr></table></blockquote><p><b>CQFM Test Case Description</b>: Example test case in a bundle illustrating expected input parameters and expected output results given those input parameters along with evaluatedResources.</p><blockquote><p><b>modifierExtension[http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isTestCase]</b></p></blockquote><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"Measure-EXM130-FHIR.html\">EXM130 - Colorectal Cancer Screening Measure</a></p><p><b>subject</b>: <a href=\"#urnuuid47709cc7-b3ec-4abc-9d26-3df3d3d57906\">See above (urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57906)</a></p><p><b>date</b>: 2019-03-14</p><p><b>reporter</b>: <a href=\"#urnuuid47709cc7-b3ec-4abc-9d26-3df3d3d57905\">See above (urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57905)</a></p><p><b>period</b>: 2018-12-31 --&gt; 2019-01-01</p><p><b>improvementNotation</b>: Increased score indicates improvement <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.4.0/CodeSystem-measure-improvement-notation.html\">MeasureImprovementNotation</a>#increase)</span></p><blockquote><p><b>group</b></p><p><b>code</b>: group-1 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (#group-1)</span></p><blockquote><p><b>population</b></p><p><b>code</b>: Initial Population <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.4.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#initial-population)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: Numerator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.4.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#numerator)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: Denominator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.4.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#denominator)</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: Denominator Exclusion <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.4.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#denominator-exclusion)</span></p><p><b>count</b>: 0</p></blockquote><p><b>measureScore</b>: 1</p></blockquote><p><b>evaluatedResource</b>: </p><ul><li><a href=\"#urnuuid47709cc7-b3ec-4abc-9d26-3df3d3d57905\">See above (urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57905)</a></li><li><a href=\"#urnuuid47709cc7-b3ec-4abc-9d26-3df3d3d57906\">See above (urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57906)</a></li><li><a href=\"#urnuuid47709cc7-b3ec-4abc-9d26-3df3d3d57907\">See above (urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57907)</a></li><li><a href=\"#urnuuid47709cc7-b3ec-4abc-9d26-3df3d3d57908\">See above (urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57908)</a></li></ul><hr/><blockquote><h2>Parameters</h2><table class=\"grid\"><tr><td>subject</td><td>123</td></tr></table></blockquote></div>"
        },
        "contained" : [
          {
            "resourceType" : "Parameters",
            "id" : "testcase-example-parameters",
            "parameter" : [
              {
                "name" : "subject",
                "valueString" : "123"
              }
            ]
          }
        ],
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-inputParameters",
            "valueReference" : {
              "reference" : "#testcase-example-parameters"
            }
          },
          {
            "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-testCaseDescription",
            "valueMarkdown" : "Example test case in a bundle illustrating expected input parameters and expected output results given those input parameters along with evaluatedResources."
          }
        ],
        "modifierExtension" : [
          {
            "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isTestCase",
            "valueBoolean" : true
          }
        ],
        "status" : "complete",
        "type" : "individual",
        "measure" : "http://hl7.org/fhir/us/cqfmeasures/Measure/EXM130-FHIR",
        "subject" : {
          "reference" : "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57906"
        },
        "date" : "2019-03-14",
        "reporter" : {
          "reference" : "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57905"
        },
        "period" : {
          "start" : "2018-12-31",
          "end" : "2019-01-01"
        },
        "improvementNotation" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
              "code" : "increase",
              "display" : "Increased score indicates improvement"
            }
          ]
        },
        "group" : [
          {
            "code" : {
              "coding" : [
                {
                  "system" : "http://example.org/fhir/",
                  "code" : "group-1",
                  "display" : "group-1"
                }
              ]
            },
            "population" : [
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code" : "initial-population",
                      "display" : "Initial Population"
                    }
                  ]
                },
                "count" : 1
              },
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code" : "numerator",
                      "display" : "Numerator"
                    }
                  ]
                },
                "count" : 1
              },
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code" : "denominator",
                      "display" : "Denominator"
                    }
                  ]
                },
                "count" : 1
              },
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                      "code" : "denominator-exclusion",
                      "display" : "Denominator Exclusion"
                    }
                  ]
                },
                "count" : 0
              }
            ],
            "measureScore" : {
              "value" : 1
            }
          }
        ],
        "evaluatedResource" : [
          {
            "reference" : "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57905"
          },
          {
            "reference" : "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57906"
          },
          {
            "reference" : "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57907"
          },
          {
            "reference" : "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57908"
          }
        ]
      },
      "request" : {
        "method" : "POST",
        "url" : "MeasureReport"
      }
    },
    {
      "fullUrl" : "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57905",
      "resource" : {
        "resourceType" : "Organization",
        "meta" : {
          "source" : "http://example.org/fhir/server",
          "profile" : [
            🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/2023Sep/StructureDefinition-qicore-organization.html\">QICore Organization</a></p></div><p><b>identifier</b>: Tax ID number:\u00a0<a href=\"http://terminology.hl7.org/5.4.0/NamingSystem-USEIN.html\">#</a>123456789\u00a0(use:\u00a0OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: Healthcare Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.4.0/CodeSystem-organization-type.html\">Organization type</a>#prov)</span></p><p><b>name</b>: DaVinciHospital01</p><p><b>telecom</b>: ph: (+1) 401-555-1212</p><p><b>address</b>: 73 Lakewood Street Warwick RI 02886 USA </p></div>"
        },
        "identifier" : [
          {
            "use" : "official",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "TAX",
                  "display" : "Tax ID number"
                }
              ]
            },
            "system" : "urn:oid:2.16.840.1.113883.4.4",
            "value" : "123456789",
            "assigner" : {
              "display" : "www.irs.gov"
            }
          }
        ],
        "active" : true,
        "type" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
                "code" : "prov",
                "display" : "Healthcare Provider"
              }
            ]
          }
        ],
        "name" : "DaVinciHospital01",
        "telecom" : [
          {
            "system" : "phone",
            "value" : "(+1) 401-555-1212"
          }
        ],
        "address" : [
          {
            "line" : [
              "73 Lakewood Street"
            ],
            "city" : "Warwick",
            "state" : "RI",
            "postalCode" : "02886",
            "country" : "USA"
          }
        ]
      },
      "request" : {
        "method" : "POST",
        "url" : "Organization"
      }
    },
    {
      "fullUrl" : "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57906",
      "resource" : {
        "resourceType" : "Patient",
        "meta" : {
          "source" : "http://example.org/fhir/server",
          "profile" : [
            🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          ]
        },
        "text" : {
          "status" : "extensions",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/2023Sep/StructureDefinition-qicore-patient.html\">QICore Patient</a></p></div><p><b>US Core Birth Sex Extension</b>: F</p><blockquote><p><b>US Core Race Extension</b></p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: White</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>identifier</b>: Medical record number:\u00a067890\u00a0(use:\u00a0USUAL)</p><p><b>active</b>: true</p><p><b>name</b>: Thelma Webster (OFFICIAL)</p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1948-04-28</p><p><b>deceased</b>: false</p><p><b>address</b>: 7496 Beaver Ridge Ave Thornton NJ 07003 USA (HOME)</p><p><b>maritalStatus</b>: Married <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.4.0/CodeSystem-v3-MaritalStatus.html\">MaritalStatus</a>#M)</span></p><h3>Communications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Language</b></td><td><b>Preferred</b></td></tr><tr><td style=\"display: none\">*</td><td>English (Region=United States) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.4.0/CodeSystem-v3-ietf3066.html\">Tags for the Identification of Languages</a>#en-US)</span></td><td>true</td></tr></table></div>"
        },
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
            "valueCode" : "F"
          },
          {
            "extension" : [
              {
                "url" : "text",
                "valueString" : "White"
              }
            ],
            "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
          },
          {
            "extension" : [
              {
                "url" : "text",
                "valueString" : "Not Hispanic or Latino"
              }
            ],
            "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
          }
        ],
        "identifier" : [
          {
            "use" : "usual",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "MR",
                  "display" : "Medical record number"
                }
              ]
            },
            "system" : "http://hospital.davinci.org",
            "value" : "67890"
          }
        ],
        "active" : true,
        "name" : [
          {
            "use" : "official",
            "family" : "Webster",
            "given" : [
              "Thelma"
            ]
          }
        ],
        "gender" : "female",
        "birthDate" : "1948-04-28",
        "deceasedBoolean" : false,
        "address" : [
          {
            "use" : "home",
            "line" : [
              "7496 Beaver Ridge Ave"
            ],
            "city" : "Thornton",
            "state" : "NJ",
            "postalCode" : "07003",
            "country" : "USA"
          }
        ],
        "maritalStatus" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
              "code" : "M",
              "display" : "Married"
            }
          ]
        },
        "communication" : [
          {
            "language" : {
              "coding" : [
                {
                  "system" : "urn:ietf:bcp:47",
                  "code" : "en-US",
                  "display" : "English (Region=United States)"
                }
              ]
            },
            "preferred" : true
          }
        ]
      },
      "request" : {
        "method" : "POST",
        "url" : "Patient"
      }
    },
    {
      "fullUrl" : "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57907",
      "resource" : {
        "resourceType" : "Practitioner",
        "meta" : {
          "source" : "http://example.org/fhir/server",
          "profile" : [
            🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Practitioner</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/2023Sep/StructureDefinition-qicore-practitioner.html\">QICore Practitioner</a></p></div><p><b>identifier</b>: Provider number:\u00a0<a href=\"http://terminology.hl7.org/5.4.0/NamingSystem-npi.html\">#</a>1881665057\u00a0(use:\u00a0OFFICIAL)</p><p><b>active</b>: true</p><p><b>name</b>: Nia Akers </p><p><b>gender</b>: female</p></div>"
        },
        "identifier" : [
          {
            "use" : "official",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "PRN",
                  "display" : "Provider number"
                }
              ]
            },
            "system" : "http://hl7.org/fhir/sid/us-npi",
            "value" : "1881665057"
          }
        ],
        "active" : true,
        "name" : [
          {
            "family" : "Akers",
            "given" : [
              "Nia"
            ],
            "suffix" : [
              "MD"
            ]
          }
        ],
        "gender" : "female"
      },
      "request" : {
        "method" : "POST",
        "url" : "Practitioner"
      }
    },
    {
      "fullUrl" : "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57908",
      "resource" : {
        "resourceType" : "Observation",
        "meta" : {
          "source" : "http://example.org/fhir/server",
          "profile" : [
            🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-simple-observation"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/qicore/2023Sep/StructureDefinition-qicore-simple-observation.html\">QICore Simple Observation</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Laboratory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.4.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#laboratory)</span></p><p><b>code</b>: Noninvasive colorectal cancer DNA and occult blood screening [Interpretation] in Stool Narrative <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#77353-1)</span></p><p><b>subject</b>: <a href=\"#urnuuid47709cc7-b3ec-4abc-9d26-3df3d3d57906\">See above (urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57906)</a></p><p><b>effective</b>: 2018-06-22</p><p><b>performer</b>: <a href=\"#urnuuid47709cc7-b3ec-4abc-9d26-3df3d3d57907\">See above (urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57907)</a></p></div>"
        },
        "status" : "final",
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                "code" : "laboratory",
                "display" : "Laboratory"
              }
            ]
          }
        ],
        "code" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "77353-1",
              "display" : "Noninvasive colorectal cancer DNA and occult blood screening [Interpretation] in Stool Narrative"
            }
          ]
        },
        "subject" : {
          "reference" : "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57906"
        },
        "effectiveDateTime" : "2018-06-22",
        "performer" : [
          {
            "reference" : "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57907"
          }
        ]
      },
      "request" : {
        "method" : "POST",
        "url" : "Observation"
      }
    }
  ]
}