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

Extension: CQFM Improvement Notation

Official URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation Version: 5.0.0-ballot
Active as of 2023-12-15 Computable Name: CQFMImprovementNotation

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 within a range).

Additional Guidance: improvementNotation

Reference range with definition of score within a defined interval (or a “passing score” over or under a certain threshold) indicates better quality to the improvement notation value set. Please provide comments on this additional code and if there are other codes needed in this value set.

Please provide comments on this additional code and if there are other codes needed in the improvement notation value set.

If an additional code is added to the improvement notation (like normative reference range as suggested), where is guidance about the reference range best included in the specification for implementer use? Some suggestions include: the guidance field, the rate aggregation field or adding an extension to improvementNotation to add text.

Purpose

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

Context of Use

This extension may be used on the following element(s):

  • Element ID Measure.group

Usage info

Usage:

Formal Views of Extension Content

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

This structure is derived from Extension

Summary

Simple Extension of type CodeableConcept: 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 within a range).

Additional Guidance: improvementNotation

Reference range with definition of score within a defined interval (or a “passing score” over or under a certain threshold) indicates better quality to the improvement notation value set. Please provide comments on this additional code and if there are other codes needed in this value set.

Please provide comments on this additional code and if there are other codes needed in the improvement notation value set.

If an additional code is added to the improvement notation (like normative reference range as suggested), where is guidance about the reference range best included in the specification for implementer use? Some suggestions include: the guidance field, the rate aggregation field or adding an extension to improvementNotation to add text.

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..1Extensionincrease | decrease
... url 1..1uri"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation"
... value[x] 0..1CodeableConceptValue of extension
Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure


doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..1Extensionincrease | decrease
... id 0..1stringUnique id for inter-element referencing
... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
... url 1..1uri"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation"

doco Documentation for this format

This structure is derived from Extension

Summary

Simple Extension of type CodeableConcept: 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 within a range).

Additional Guidance: improvementNotation

Reference range with definition of score within a defined interval (or a “passing score” over or under a certain threshold) indicates better quality to the improvement notation value set. Please provide comments on this additional code and if there are other codes needed in this value set.

Please provide comments on this additional code and if there are other codes needed in the improvement notation value set.

If an additional code is added to the improvement notation (like normative reference range as suggested), where is guidance about the reference range best included in the specification for implementer use? Some suggestions include: the guidance field, the rate aggregation field or adding an extension to improvementNotation to add text.

Differential View

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..1Extensionincrease | decrease
... url 1..1uri"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation"
... value[x] 0..1CodeableConceptValue of extension
Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure


doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..1Extensionincrease | decrease
... id 0..1stringUnique id for inter-element referencing
... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
... url 1..1uri"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation"

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSet
Extension.value[x]requiredMeasureImprovementNotation

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()