Quality Measure Implementation Guide (STU5)
5.0.0-ballot - ballot United States of America flag

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

Resource Profile: CQFM Publishable Measure

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

The CQFM Publishable Measure profile defines the minimum expectations to enable appropriate content management, discovery, and utilization of published electronic Clinical Quality Measures (eCQMs)

Usage:

Formal Views of Profile Content

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

This structure is derived from CQFMMeasure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure 1..1CQFMMeasureA quality measure definition
... text S1..1NarrativeText summary of the resource, for human interpretation
... supplementalDataGuidance S0..*(Complex)Supplemental data guidance
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance
... Slices for identifier S3..*IdentifierAdditional identifier for the measure
Slice: Unordered, Open by value:type
.... identifier:versionIndependentIdentifier S1..1IdentifierMeasure guid
..... use S1..1codeusual | official | temp | secondary | old (If known)
Fixed Value: official
..... type S1..1CodeableConceptDescription of identifier
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: version-independent
..... system S1..1uriThe namespace for the identifier value
Fixed Value: urn:ietf:rfc:3986
..... value S1..1stringThe value that is unique
.... identifier:versionSpecificIdentifier S1..1IdentifierMeasure version guid
..... use S1..1codeusual | official | temp | secondary | old (If known)
Fixed Value: official
..... type S1..1CodeableConceptDescription of identifier
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: version-specific
..... system S1..1uriThe namespace for the identifier value
Fixed Value: urn:ietf:rfc:3986
..... value S1..1stringThe value that is unique
.... identifier:shortName S1..1IdentifierShort name
..... use S1..1codeusual | official | temp | secondary | old (If known)
Fixed Value: usual
..... type S1..1CodeableConceptDescription of identifier
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: short-name
..... value S1..1stringThe value that is unique
.... identifier:endorserIdentifier S0..*IdentifierEndorser identifier
..... use S1..1codeusual | official | temp | secondary | old (If known)
Fixed Value: official
..... type S1..1CodeableConceptDescription of identifier
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: endorser
..... system S0..1uriThe namespace for the identifier value
..... value S1..1stringThe value that is unique
..... assigner S1..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:publisherIdentifier S0..*IdentifierPublisher identifier
..... use S1..1codeusual | official | temp | secondary | old (If known)
Fixed Value: official
..... type S1..1CodeableConceptDescription of identifier
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: publisher
..... system S0..1uriThe namespace for the identifier value
..... value S1..1stringThe value that is unique
..... assigner S1..1Reference(Organization)Organization that issued id (may be just text)
... status 1..1codedraft | active | retired | unknown
Fixed Value: active
... date S1..1dateTimeDate last changed
... publisher 1..1stringName of the publisher (organization or individual)
... contact S1..*ContactDetailContact details for the publisher
... purpose S0..1markdownWhy this measure is defined
... usage S0..1stringAllows measure developers to provide additional guidance so that implementers can more easily interpret and implement components of the measure.
... copyright S0..1markdownUse and/or publishing restrictions
... approvalDate S0..1dateWhen the measure was approved by publisher
... lastReviewDate S0..1dateWhen the measure was last reviewed
... effectivePeriod S0..1PeriodWhen the measure is expected to be used
.... anchor S0..1dateTimeDate of first effective use
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodAnchor
.... duration S0..1DurationWhat reporting period is used
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodDuration
... topic S0..*CodeableConceptThe category of the measure, such as Education, Treatment, Assessment, etc.
... author S0..*ContactDetailWho authored the content
... editor S0..*ContactDetailWho edited the content
... reviewer S0..*ContactDetailWho reviewed the content
... endorser S0..*ContactDetailWho endorsed the content
... Slices for relatedArtifact S0..*RelatedArtifactAdditional documentation, citations, etc.
Slice: Unordered, Open by value:type
.... relatedArtifact:predecessor S0..1RelatedArtifactPrevious measure?
..... type S1..1codedocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Fixed Value: predecessor
..... resource S1..1canonical(Measure)What resource is being referenced
.... relatedArtifact:citation S0..*RelatedArtifactReference/citation
..... isPrimaryCitation 0..1booleanPrimary reference
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isPrimaryCitation
..... publicationStatus 0..1codePublication status of referenced artifact
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-publicationStatus
Binding: PublicationStatus (required): The lifecycle status of a reference artifact

..... publicationDate 0..1datePublication date of referenced artifact
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-publicationDate
..... type S1..1codedocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Fixed Value: citation
.... relatedArtifact:derived-from S0..*RelatedArtifactURL or canonical reference to other resources that a measure is derived from
..... type S1..1codedocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Fixed Value: derived-from
..... label 0..1stringShort label
..... display 0..1stringBrief description of the related artifact
..... url 0..1urlShould be permalink otherwise include an "accessed date"
..... resource 0..1canonical(Measure)Should be permalink otherwise include an "accessed date"
... disclaimer S0..1markdownDisclaimer for use of the measure or its referenced content
... rationale 0..1markdownDetailed description of why the measure exists
... definition 0..*markdownDefined terms used in the measure documentation
.... definitionTerm 1..1(Complex)Defined term
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-definitionTerm
... guidance 0..0

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure C1..1CQFMMeasureA quality measure definition
... meta SΣ1..1MetaMetadata about the resource
.... profile SΣ1..*canonical(StructureDefinition)Profiles this resource claims to conform to
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text S1..1NarrativeText summary of the resource, for human interpretation
... comment S0..*(Complex)Additional documentation, review, or usage guidance
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-artifactComment
... softwaresystem S0..*Reference(CQFM Device)Extension
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem
... supplementalDataGuidance S0..*(Complex)Supplemental data guidance
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... url Σ1..1uriCanonical identifier for this measure, represented as a URI (globally unique)
... Slices for identifier SΣ3..*IdentifierAdditional identifier for the measure
Slice: Unordered, Open by value:type
.... identifier:versionIndependentIdentifier SΣ1..1IdentifierMeasure guid
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: official
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: version-independent
..... system SΣ1..1uriThe namespace for the identifier value
Fixed Value: urn:ietf:rfc:3986
..... value SΣ1..1stringThe value that is unique
Example General: 123456
.... identifier:versionSpecificIdentifier SΣ1..1IdentifierMeasure version guid
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: official
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: version-specific
..... system SΣ1..1uriThe namespace for the identifier value
Fixed Value: urn:ietf:rfc:3986
..... value SΣ1..1stringThe value that is unique
Example General: 123456
.... identifier:shortName SΣ1..1IdentifierShort name
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: usual
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: short-name
..... value SΣ1..1stringThe value that is unique
Example General: 123456
.... identifier:endorserIdentifier SΣ0..*IdentifierEndorser identifier
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: official
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: endorser
..... system SΣ0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ1..1stringThe value that is unique
Example General: 123456
..... assigner SΣ1..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:publisherIdentifier SΣ0..*IdentifierPublisher identifier
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: official
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: publisher
..... system SΣ0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ1..1stringThe value that is unique
Example General: 123456
..... assigner SΣ1..1Reference(Organization)Organization that issued id (may be just text)
... version Σ1..1stringBusiness version of the measure
... name ΣC1..1stringName for this measure (computer friendly)
... title SΣ1..1stringName for this measure (human friendly)
... status ?!Σ1..1codedraft | active | retired | unknown
Binding: PublicationStatus (required): The lifecycle status of an artifact.


Fixed Value: active
... experimental Σ1..1booleanFor testing purposes, not real usage
... date SΣ1..1dateTimeDate last changed
... publisher Σ1..1stringName of the publisher (organization or individual)
... contact SΣ1..*ContactDetailContact details for the publisher
... description Σ1..1markdownNatural language description of the measure
... useContext SΣ0..*UsageContextThe context that the content is intended to support
... jurisdiction SΣ0..*CodeableConceptIntended jurisdiction for measure (if applicable)
Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.


... purpose S0..1markdownWhy this measure is defined
... usage S0..1stringAllows measure developers to provide additional guidance so that implementers can more easily interpret and implement components of the measure.
... copyright S0..1markdownUse and/or publishing restrictions
... approvalDate S0..1dateWhen the measure was approved by publisher
... lastReviewDate S0..1dateWhen the measure was last reviewed
... effectivePeriod SΣ0..1PeriodWhen the measure is expected to be used
.... anchor S0..1dateTimeDate of first effective use
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodAnchor
.... duration S0..1DurationWhat reporting period is used
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodDuration
... topic S0..*CodeableConceptThe category of the measure, such as Education, Treatment, Assessment, etc.
Binding: DefinitionTopic (example): High-level categorization of the definition, used for searching, sorting, and filtering.


... author S0..*ContactDetailWho authored the content
... editor S0..*ContactDetailWho edited the content
... reviewer S0..*ContactDetailWho reviewed the content
... endorser S0..*ContactDetailWho endorsed the content
... Slices for relatedArtifact S0..*RelatedArtifactAdditional documentation, citations, etc.
Slice: Unordered, Open by value:type
.... relatedArtifact:predecessor S0..1RelatedArtifactPrevious measure?
..... type SΣ1..1codedocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Binding: RelatedArtifactType (required): The type of relationship to the related artifact.


Fixed Value: predecessor
..... resource SΣ1..1canonical(Measure)What resource is being referenced
.... relatedArtifact:citation S0..*RelatedArtifactReference/citation
..... isPrimaryCitation 0..1booleanPrimary reference
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isPrimaryCitation
..... publicationStatus 0..1codePublication status of referenced artifact
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-publicationStatus
Binding: PublicationStatus (required): The lifecycle status of a reference artifact


..... publicationDate 0..1datePublication date of referenced artifact
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-publicationDate
..... type SΣ1..1codedocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Binding: RelatedArtifactType (required): The type of relationship to the related artifact.


Fixed Value: citation
.... relatedArtifact:derived-from S0..*RelatedArtifactURL or canonical reference to other resources that a measure is derived from
..... type SΣ1..1codedocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Binding: RelatedArtifactType (required): The type of relationship to the related artifact.


Fixed Value: derived-from
..... label Σ0..1stringShort label
..... display Σ0..1stringBrief description of the related artifact
..... url Σ0..1urlShould be permalink otherwise include an "accessed date"
..... resource Σ0..1canonical(Measure)Should be permalink otherwise include an "accessed date"
... library SC0..1canonical(CQFM Library)CQFMMeasures are not required to use a Library, but if they do, it SHALL be a CQFMLibrary.
... disclaimer SΣ0..1markdownDisclaimer for use of the measure or its referenced content
... type SΣ0..*CodeableConceptprocess | outcome | structure | patient-reported-outcome | composite
Binding: MeasureType (extensible)
... rationale Σ0..1markdownDetailed description of why the measure exists
... definition Σ0..*markdownDefined terms used in the measure documentation
.... Slices for extension 1..*ExtensionExtension
Slice: Unordered, Open by value:url
.... definitionTerm 1..1(Complex)Defined term
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-definitionTerm
... group S0..*BackboneElementPopulation criteria group
.... id SC0..1stringUnique id for inter-element referencing
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... population S0..*BackboneElementPopulation criteria
..... id S1..1stringUnique id for inter-element referencing
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code S1..1CodeableConceptinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible)
..... criteria SC1..1ExpressionThe criteria that defines this population. The alternativeExpression extension may be used to provide alternative formulations of the expression
.... stratifier S0..*BackboneElementStratifier criteria for the measure
..... id S1..1stringUnique id for inter-element referencing
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... criteria SC1..1ExpressionHow the measure should be stratified. The alternativeExpression extension may be used to provide alternative formulations of the expression
... supplementalData S0..*BackboneElementWhat other data should be reported with the measure
.... id S1..1stringUnique id for inter-element referencing
.... includeInReportType 0..*codeThe type of report the element should be included in
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType
Binding: MeasureReportType (required): The type of report the element should be included in


.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code S0..1CodeableConceptMeaning of the supplemental data
Binding: MeasureSupplementalData (preferred)
.... criteria 1..1ExpressionExpression describing additional data to be reported

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Measure.identifier:versionIndependentIdentifier.userequiredFixed Value: official
Measure.identifier:versionIndependentIdentifier.typeextensiblePattern: version-independent
Measure.identifier:versionSpecificIdentifier.userequiredFixed Value: official
Measure.identifier:versionSpecificIdentifier.typeextensiblePattern: version-specific
Measure.identifier:shortName.userequiredFixed Value: usual
Measure.identifier:shortName.typeextensiblePattern: short-name
Measure.identifier:endorserIdentifier.userequiredFixed Value: official
Measure.identifier:endorserIdentifier.typeextensiblePattern: endorser
Measure.identifier:publisherIdentifier.userequiredFixed Value: official
Measure.identifier:publisherIdentifier.typeextensiblePattern: publisher
Measure.statusrequiredFixed Value: active
Measure.jurisdictionextensibleJurisdiction ValueSet
Measure.topicexampleDefinitionTopic
Measure.relatedArtifact:predecessor.typerequiredFixed Value: predecessor
Measure.relatedArtifact:citation.typerequiredFixed Value: citation
Measure.relatedArtifact:derived-from.typerequiredFixed Value: derived-from
Measure.typeextensibleMeasureType
Measure.group.population.codeextensibleMeasurePopulationType
Measure.supplementalData.codepreferredMeasureSupplementalData

Constraints

IdGradePath(s)DetailsRequirements
cqm-2warningMeasure.libraryMeasures utilizing CQL SHALL reference one and only one CQL library (and that referenced library MUST be the primary library for the measure)
: exists()
cqm-3warningMeasure.group.idGroup identifiers SHOULD use the convention: "group-[group number]", where [group number] corresponds with the group naming convention for the criteria within the group
: startsWith('group-')
cqm-4warningMeasure.group.population.criteriaGroup population criteria SHOULD be simple expression names found within the primary library for the measure. The criteria SHOULD NOT include a namespace.
: expression.contains('.').not()
cqm-5warningMeasure.group.stratifier.criteriaGroup stratifier criteria SHOULD be simple expression names found within the primary library for the measure. The criteria SHOULD NOT include a namespace.
: expression.contains('.').not()
dom-2errorMeasureIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMeasureIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMeasureIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMeasureIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMeasureA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mea-0warningMeasureName should be usable as an identifier for the module by machine processing applications such as code generation
: name.matches('[A-Z]([A-Za-z0-9_]){0,254}')
mea-1errorMeasureStratifier SHALL be either a single criteria or a set of criteria components
: group.stratifier.all((code | description | criteria).exists() xor component.exists())
NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure C1..1CQFMMeasureA quality measure definition
... id Σ0..1idLogical id of this artifact
... meta SΣ1..1MetaMetadata about the resource
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ0..1idVersion specific identifier
.... lastUpdated Σ0..1instantWhen the resource version last changed
.... source Σ0..1uriIdentifies where the resource comes from
.... profile SΣ1..*canonical(StructureDefinition)Profiles this resource claims to conform to
.... security Σ0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... tag Σ0..*CodingTags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text S1..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... comment S0..*(Complex)Additional documentation, review, or usage guidance
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-artifactComment
... softwaresystem S0..*Reference(CQFM Device)Extension
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem
... supplementalDataGuidance S0..*(Complex)Supplemental data guidance
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... url Σ1..1uriCanonical identifier for this measure, represented as a URI (globally unique)
... Slices for identifier SΣ3..*IdentifierAdditional identifier for the measure
Slice: Unordered, Open by value:type
.... identifier:versionIndependentIdentifier SΣ1..1IdentifierMeasure guid
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: official
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: version-independent
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... system SΣ1..1uriThe namespace for the identifier value
Fixed Value: urn:ietf:rfc:3986
..... value SΣ1..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:versionSpecificIdentifier SΣ1..1IdentifierMeasure version guid
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: official
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: version-specific
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... system SΣ1..1uriThe namespace for the identifier value
Fixed Value: urn:ietf:rfc:3986
..... value SΣ1..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:shortName SΣ1..1IdentifierShort name
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: usual
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: short-name
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... system Σ0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ1..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:endorserIdentifier SΣ0..*IdentifierEndorser identifier
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: official
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: endorser
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... system SΣ0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ1..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner SΣ1..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:publisherIdentifier SΣ0..*IdentifierPublisher identifier
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: official
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: publisher
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... system SΣ0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ1..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner SΣ1..1Reference(Organization)Organization that issued id (may be just text)
... version Σ1..1stringBusiness version of the measure
... name ΣC1..1stringName for this measure (computer friendly)
... title SΣ1..1stringName for this measure (human friendly)
... subtitle 0..1stringSubordinate title of the measure
... status ?!Σ1..1codedraft | active | retired | unknown
Binding: PublicationStatus (required): The lifecycle status of an artifact.


Fixed Value: active
... experimental Σ1..1booleanFor testing purposes, not real usage
... subject[x] 0..1E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
Binding: SubjectType (extensible): The possible types of subjects for a measure (E.g. Patient, Practitioner, Organization, Location, etc.).

.... subjectCodeableConceptCodeableConcept
.... subjectReferenceReference(Group)
... date SΣ1..1dateTimeDate last changed
... publisher Σ1..1stringName of the publisher (organization or individual)
... contact SΣ1..*ContactDetailContact details for the publisher
... description Σ1..1markdownNatural language description of the measure
... useContext SΣ0..*UsageContextThe context that the content is intended to support
... jurisdiction SΣ0..*CodeableConceptIntended jurisdiction for measure (if applicable)
Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.


... purpose S0..1markdownWhy this measure is defined
... usage S0..1stringAllows measure developers to provide additional guidance so that implementers can more easily interpret and implement components of the measure.
... copyright S0..1markdownUse and/or publishing restrictions
... approvalDate S0..1dateWhen the measure was approved by publisher
... lastReviewDate S0..1dateWhen the measure was last reviewed
... effectivePeriod SΣ0..1PeriodWhen the measure is expected to be used
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... anchor S0..1dateTimeDate of first effective use
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodAnchor
.... duration S0..1DurationWhat reporting period is used
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodDuration
.... start ΣC0..1dateTimeStarting time with inclusive boundary
.... end ΣC0..1dateTimeEnd time with inclusive boundary, if not ongoing
... topic S0..*CodeableConceptThe category of the measure, such as Education, Treatment, Assessment, etc.
Binding: DefinitionTopic (example): High-level categorization of the definition, used for searching, sorting, and filtering.


... author S0..*ContactDetailWho authored the content
... editor S0..*ContactDetailWho edited the content
... reviewer S0..*ContactDetailWho reviewed the content
... endorser S0..*ContactDetailWho endorsed the content
... Slices for relatedArtifact S0..*RelatedArtifactAdditional documentation, citations, etc.
Slice: Unordered, Open by value:type
.... relatedArtifact:predecessor S0..1RelatedArtifactPrevious measure?
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... type SΣ1..1codedocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Binding: RelatedArtifactType (required): The type of relationship to the related artifact.


Fixed Value: predecessor
..... label Σ0..1stringShort label
..... display Σ0..1stringBrief description of the related artifact
..... citation Σ0..1markdownBibliographic citation for the artifact
..... url Σ0..1urlWhere the artifact can be accessed
..... document Σ0..1AttachmentWhat document is being referenced
..... resource SΣ1..1canonical(Measure)What resource is being referenced
.... relatedArtifact:citation S0..*RelatedArtifactReference/citation
..... id 0..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... isPrimaryCitation 0..1booleanPrimary reference
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isPrimaryCitation
..... publicationStatus 0..1codePublication status of referenced artifact
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-publicationStatus
Binding: PublicationStatus (required): The lifecycle status of a reference artifact


..... publicationDate 0..1datePublication date of referenced artifact
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-publicationDate
..... type SΣ1..1codedocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Binding: RelatedArtifactType (required): The type of relationship to the related artifact.


Fixed Value: citation
..... label Σ0..1stringShort label
..... display Σ0..1stringBrief description of the related artifact
..... citation Σ0..1markdownBibliographic citation for the artifact
..... url Σ0..1urlWhere the artifact can be accessed
..... document Σ0..1AttachmentWhat document is being referenced
..... resource Σ0..1canonical(Resource)What resource is being referenced
.... relatedArtifact:derived-from S0..*RelatedArtifactURL or canonical reference to other resources that a measure is derived from
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... type SΣ1..1codedocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Binding: RelatedArtifactType (required): The type of relationship to the related artifact.


Fixed Value: derived-from
..... label Σ0..1stringShort label
..... display Σ0..1stringBrief description of the related artifact
..... citation Σ0..1markdownBibliographic citation for the artifact
..... url Σ0..1urlShould be permalink otherwise include an "accessed date"
..... document Σ0..1AttachmentWhat document is being referenced
..... resource Σ0..1canonical(Measure)Should be permalink otherwise include an "accessed date"
... library SC0..1canonical(CQFM Library)CQFMMeasures are not required to use a Library, but if they do, it SHALL be a CQFMLibrary.
... disclaimer SΣ0..1markdownDisclaimer for use of the measure or its referenced content
... scoring Σ0..1CodeableConceptproportion | ratio | continuous-variable | cohort
Binding: MeasureScoring (extensible): The scoring type of the measure.

... compositeScoring Σ0..1CodeableConceptopportunity | all-or-nothing | linear | weighted
Binding: CompositeMeasureScoring (extensible): The composite scoring method of the measure.

... type SΣ0..*CodeableConceptprocess | outcome | structure | patient-reported-outcome | composite
Binding: MeasureType (extensible)
... riskAdjustment Σ0..1stringHow risk adjustment is applied for this measure
... rateAggregation Σ0..1stringHow is rate aggregation performed for this measure
... rationale Σ0..1markdownDetailed description of why the measure exists
... clinicalRecommendationStatement Σ0..1markdownSummary of clinical guidelines
... improvementNotation Σ0..1CodeableConceptincrease | decrease
Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.

... definition Σ0..*markdownDefined terms used in the measure documentation
.... id 0..1stringxml:id (or equivalent in JSON)
.... Slices for extension 1..*ExtensionExtension
Slice: Unordered, Open by value:url
.... definitionTerm 1..1(Complex)Defined term
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-definitionTerm
.... value 0..1stringPrimitive value for markdown
... group S0..*BackboneElementPopulation criteria group
.... id SC0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code 0..1CodeableConceptMeaning of the group
.... description 0..1stringSummary description
.... population S0..*BackboneElementPopulation criteria
..... id S1..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code S1..1CodeableConceptinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible)
..... description 0..1stringThe human readable description of this population criteria
..... criteria SC1..1ExpressionThe criteria that defines this population. The alternativeExpression extension may be used to provide alternative formulations of the expression
.... stratifier S0..*BackboneElementStratifier criteria for the measure
..... id S1..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code 0..1CodeableConceptMeaning of the stratifier
..... description 0..1stringThe human readable description of this stratifier
..... criteria SC1..1ExpressionHow the measure should be stratified. The alternativeExpression extension may be used to provide alternative formulations of the expression
..... component 0..*BackboneElementStratifier criteria component for the measure
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... code 0..1CodeableConceptMeaning of the stratifier component
...... description 0..1stringThe human readable description of this stratifier component
...... criteria 1..1ExpressionComponent of how the measure should be stratified
... supplementalData S0..*BackboneElementWhat other data should be reported with the measure
.... id S1..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
.... includeInReportType 0..*codeThe type of report the element should be included in
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType
Binding: MeasureReportType (required): The type of report the element should be included in


.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code S0..1CodeableConceptMeaning of the supplemental data
Binding: MeasureSupplementalData (preferred)
.... usage 0..*CodeableConceptsupplemental-data | risk-adjustment-factor
Binding: MeasureDataUsage (preferred)
.... description 0..1stringThe human readable description of this supplemental data
.... criteria 1..1ExpressionExpression describing additional data to be reported

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Measure.meta.securityextensibleAll Security Labels
Measure.meta.tagexampleCommonTags
Measure.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Measure.identifier:versionIndependentIdentifier.userequiredFixed Value: official
Measure.identifier:versionIndependentIdentifier.typeextensiblePattern: version-independent
Measure.identifier:versionSpecificIdentifier.userequiredFixed Value: official
Measure.identifier:versionSpecificIdentifier.typeextensiblePattern: version-specific
Measure.identifier:shortName.userequiredFixed Value: usual
Measure.identifier:shortName.typeextensiblePattern: short-name
Measure.identifier:endorserIdentifier.userequiredFixed Value: official
Measure.identifier:endorserIdentifier.typeextensiblePattern: endorser
Measure.identifier:publisherIdentifier.userequiredFixed Value: official
Measure.identifier:publisherIdentifier.typeextensiblePattern: publisher
Measure.statusrequiredFixed Value: active
Measure.subject[x]extensibleSubjectType
Measure.jurisdictionextensibleJurisdiction ValueSet
Measure.topicexampleDefinitionTopic
Measure.relatedArtifact:predecessor.typerequiredFixed Value: predecessor
Measure.relatedArtifact:citation.typerequiredFixed Value: citation
Measure.relatedArtifact:derived-from.typerequiredFixed Value: derived-from
Measure.scoringextensibleMeasureScoring
Measure.compositeScoringextensibleCompositeMeasureScoring
Measure.typeextensibleMeasureType
Measure.improvementNotationrequiredMeasureImprovementNotation
Measure.group.population.codeextensibleMeasurePopulationType
Measure.supplementalData.codepreferredMeasureSupplementalData
Measure.supplementalData.usagepreferredMeasureDataUsage

Constraints

IdGradePath(s)DetailsRequirements
cqm-2warningMeasure.libraryMeasures utilizing CQL SHALL reference one and only one CQL library (and that referenced library MUST be the primary library for the measure)
: exists()
cqm-3warningMeasure.group.idGroup identifiers SHOULD use the convention: "group-[group number]", where [group number] corresponds with the group naming convention for the criteria within the group
: startsWith('group-')
cqm-4warningMeasure.group.population.criteriaGroup population criteria SHOULD be simple expression names found within the primary library for the measure. The criteria SHOULD NOT include a namespace.
: expression.contains('.').not()
cqm-5warningMeasure.group.stratifier.criteriaGroup stratifier criteria SHOULD be simple expression names found within the primary library for the measure. The criteria SHOULD NOT include a namespace.
: expression.contains('.').not()
dom-2errorMeasureIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMeasureIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMeasureIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMeasureIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMeasureA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mea-0warningMeasureName should be usable as an identifier for the module by machine processing applications such as code generation
: name.matches('[A-Z]([A-Za-z0-9_]){0,254}')
mea-1errorMeasureStratifier SHALL be either a single criteria or a set of criteria components
: group.stratifier.all((code | description | criteria).exists() xor component.exists())

This structure is derived from CQFMMeasure

Summary

Mandatory: 20 elements (13 nested mandatory elements)
Must-Support: 54 elements
Fixed Value: 11 elements
Prohibited: 1 element

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Measure.identifier is sliced based on the value of value:type
  • The element Measure.relatedArtifact is sliced based on the value of value:type

Differential View

This structure is derived from CQFMMeasure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure 1..1CQFMMeasureA quality measure definition
... text S1..1NarrativeText summary of the resource, for human interpretation
... supplementalDataGuidance S0..*(Complex)Supplemental data guidance
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance
... Slices for identifier S3..*IdentifierAdditional identifier for the measure
Slice: Unordered, Open by value:type
.... identifier:versionIndependentIdentifier S1..1IdentifierMeasure guid
..... use S1..1codeusual | official | temp | secondary | old (If known)
Fixed Value: official
..... type S1..1CodeableConceptDescription of identifier
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: version-independent
..... system S1..1uriThe namespace for the identifier value
Fixed Value: urn:ietf:rfc:3986
..... value S1..1stringThe value that is unique
.... identifier:versionSpecificIdentifier S1..1IdentifierMeasure version guid
..... use S1..1codeusual | official | temp | secondary | old (If known)
Fixed Value: official
..... type S1..1CodeableConceptDescription of identifier
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: version-specific
..... system S1..1uriThe namespace for the identifier value
Fixed Value: urn:ietf:rfc:3986
..... value S1..1stringThe value that is unique
.... identifier:shortName S1..1IdentifierShort name
..... use S1..1codeusual | official | temp | secondary | old (If known)
Fixed Value: usual
..... type S1..1CodeableConceptDescription of identifier
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: short-name
..... value S1..1stringThe value that is unique
.... identifier:endorserIdentifier S0..*IdentifierEndorser identifier
..... use S1..1codeusual | official | temp | secondary | old (If known)
Fixed Value: official
..... type S1..1CodeableConceptDescription of identifier
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: endorser
..... system S0..1uriThe namespace for the identifier value
..... value S1..1stringThe value that is unique
..... assigner S1..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:publisherIdentifier S0..*IdentifierPublisher identifier
..... use S1..1codeusual | official | temp | secondary | old (If known)
Fixed Value: official
..... type S1..1CodeableConceptDescription of identifier
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: publisher
..... system S0..1uriThe namespace for the identifier value
..... value S1..1stringThe value that is unique
..... assigner S1..1Reference(Organization)Organization that issued id (may be just text)
... status 1..1codedraft | active | retired | unknown
Fixed Value: active
... date S1..1dateTimeDate last changed
... publisher 1..1stringName of the publisher (organization or individual)
... contact S1..*ContactDetailContact details for the publisher
... purpose S0..1markdownWhy this measure is defined
... usage S0..1stringAllows measure developers to provide additional guidance so that implementers can more easily interpret and implement components of the measure.
... copyright S0..1markdownUse and/or publishing restrictions
... approvalDate S0..1dateWhen the measure was approved by publisher
... lastReviewDate S0..1dateWhen the measure was last reviewed
... effectivePeriod S0..1PeriodWhen the measure is expected to be used
.... anchor S0..1dateTimeDate of first effective use
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodAnchor
.... duration S0..1DurationWhat reporting period is used
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodDuration
... topic S0..*CodeableConceptThe category of the measure, such as Education, Treatment, Assessment, etc.
... author S0..*ContactDetailWho authored the content
... editor S0..*ContactDetailWho edited the content
... reviewer S0..*ContactDetailWho reviewed the content
... endorser S0..*ContactDetailWho endorsed the content
... Slices for relatedArtifact S0..*RelatedArtifactAdditional documentation, citations, etc.
Slice: Unordered, Open by value:type
.... relatedArtifact:predecessor S0..1RelatedArtifactPrevious measure?
..... type S1..1codedocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Fixed Value: predecessor
..... resource S1..1canonical(Measure)What resource is being referenced
.... relatedArtifact:citation S0..*RelatedArtifactReference/citation
..... isPrimaryCitation 0..1booleanPrimary reference
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isPrimaryCitation
..... publicationStatus 0..1codePublication status of referenced artifact
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-publicationStatus
Binding: PublicationStatus (required): The lifecycle status of a reference artifact

..... publicationDate 0..1datePublication date of referenced artifact
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-publicationDate
..... type S1..1codedocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Fixed Value: citation
.... relatedArtifact:derived-from S0..*RelatedArtifactURL or canonical reference to other resources that a measure is derived from
..... type S1..1codedocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Fixed Value: derived-from
..... label 0..1stringShort label
..... display 0..1stringBrief description of the related artifact
..... url 0..1urlShould be permalink otherwise include an "accessed date"
..... resource 0..1canonical(Measure)Should be permalink otherwise include an "accessed date"
... disclaimer S0..1markdownDisclaimer for use of the measure or its referenced content
... rationale 0..1markdownDetailed description of why the measure exists
... definition 0..*markdownDefined terms used in the measure documentation
.... definitionTerm 1..1(Complex)Defined term
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-definitionTerm
... guidance 0..0

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure C1..1CQFMMeasureA quality measure definition
... meta SΣ1..1MetaMetadata about the resource
.... profile SΣ1..*canonical(StructureDefinition)Profiles this resource claims to conform to
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text S1..1NarrativeText summary of the resource, for human interpretation
... comment S0..*(Complex)Additional documentation, review, or usage guidance
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-artifactComment
... softwaresystem S0..*Reference(CQFM Device)Extension
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem
... supplementalDataGuidance S0..*(Complex)Supplemental data guidance
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... url Σ1..1uriCanonical identifier for this measure, represented as a URI (globally unique)
... Slices for identifier SΣ3..*IdentifierAdditional identifier for the measure
Slice: Unordered, Open by value:type
.... identifier:versionIndependentIdentifier SΣ1..1IdentifierMeasure guid
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: official
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: version-independent
..... system SΣ1..1uriThe namespace for the identifier value
Fixed Value: urn:ietf:rfc:3986
..... value SΣ1..1stringThe value that is unique
Example General: 123456
.... identifier:versionSpecificIdentifier SΣ1..1IdentifierMeasure version guid
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: official
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: version-specific
..... system SΣ1..1uriThe namespace for the identifier value
Fixed Value: urn:ietf:rfc:3986
..... value SΣ1..1stringThe value that is unique
Example General: 123456
.... identifier:shortName SΣ1..1IdentifierShort name
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: usual
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: short-name
..... value SΣ1..1stringThe value that is unique
Example General: 123456
.... identifier:endorserIdentifier SΣ0..*IdentifierEndorser identifier
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: official
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: endorser
..... system SΣ0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ1..1stringThe value that is unique
Example General: 123456
..... assigner SΣ1..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:publisherIdentifier SΣ0..*IdentifierPublisher identifier
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: official
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: publisher
..... system SΣ0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ1..1stringThe value that is unique
Example General: 123456
..... assigner SΣ1..1Reference(Organization)Organization that issued id (may be just text)
... version Σ1..1stringBusiness version of the measure
... name ΣC1..1stringName for this measure (computer friendly)
... title SΣ1..1stringName for this measure (human friendly)
... status ?!Σ1..1codedraft | active | retired | unknown
Binding: PublicationStatus (required): The lifecycle status of an artifact.


Fixed Value: active
... experimental Σ1..1booleanFor testing purposes, not real usage
... date SΣ1..1dateTimeDate last changed
... publisher Σ1..1stringName of the publisher (organization or individual)
... contact SΣ1..*ContactDetailContact details for the publisher
... description Σ1..1markdownNatural language description of the measure
... useContext SΣ0..*UsageContextThe context that the content is intended to support
... jurisdiction SΣ0..*CodeableConceptIntended jurisdiction for measure (if applicable)
Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.


... purpose S0..1markdownWhy this measure is defined
... usage S0..1stringAllows measure developers to provide additional guidance so that implementers can more easily interpret and implement components of the measure.
... copyright S0..1markdownUse and/or publishing restrictions
... approvalDate S0..1dateWhen the measure was approved by publisher
... lastReviewDate S0..1dateWhen the measure was last reviewed
... effectivePeriod SΣ0..1PeriodWhen the measure is expected to be used
.... anchor S0..1dateTimeDate of first effective use
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodAnchor
.... duration S0..1DurationWhat reporting period is used
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodDuration
... topic S0..*CodeableConceptThe category of the measure, such as Education, Treatment, Assessment, etc.
Binding: DefinitionTopic (example): High-level categorization of the definition, used for searching, sorting, and filtering.


... author S0..*ContactDetailWho authored the content
... editor S0..*ContactDetailWho edited the content
... reviewer S0..*ContactDetailWho reviewed the content
... endorser S0..*ContactDetailWho endorsed the content
... Slices for relatedArtifact S0..*RelatedArtifactAdditional documentation, citations, etc.
Slice: Unordered, Open by value:type
.... relatedArtifact:predecessor S0..1RelatedArtifactPrevious measure?
..... type SΣ1..1codedocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Binding: RelatedArtifactType (required): The type of relationship to the related artifact.


Fixed Value: predecessor
..... resource SΣ1..1canonical(Measure)What resource is being referenced
.... relatedArtifact:citation S0..*RelatedArtifactReference/citation
..... isPrimaryCitation 0..1booleanPrimary reference
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isPrimaryCitation
..... publicationStatus 0..1codePublication status of referenced artifact
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-publicationStatus
Binding: PublicationStatus (required): The lifecycle status of a reference artifact


..... publicationDate 0..1datePublication date of referenced artifact
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-publicationDate
..... type SΣ1..1codedocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Binding: RelatedArtifactType (required): The type of relationship to the related artifact.


Fixed Value: citation
.... relatedArtifact:derived-from S0..*RelatedArtifactURL or canonical reference to other resources that a measure is derived from
..... type SΣ1..1codedocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Binding: RelatedArtifactType (required): The type of relationship to the related artifact.


Fixed Value: derived-from
..... label Σ0..1stringShort label
..... display Σ0..1stringBrief description of the related artifact
..... url Σ0..1urlShould be permalink otherwise include an "accessed date"
..... resource Σ0..1canonical(Measure)Should be permalink otherwise include an "accessed date"
... library SC0..1canonical(CQFM Library)CQFMMeasures are not required to use a Library, but if they do, it SHALL be a CQFMLibrary.
... disclaimer SΣ0..1markdownDisclaimer for use of the measure or its referenced content
... type SΣ0..*CodeableConceptprocess | outcome | structure | patient-reported-outcome | composite
Binding: MeasureType (extensible)
... rationale Σ0..1markdownDetailed description of why the measure exists
... definition Σ0..*markdownDefined terms used in the measure documentation
.... Slices for extension 1..*ExtensionExtension
Slice: Unordered, Open by value:url
.... definitionTerm 1..1(Complex)Defined term
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-definitionTerm
... group S0..*BackboneElementPopulation criteria group
.... id SC0..1stringUnique id for inter-element referencing
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... population S0..*BackboneElementPopulation criteria
..... id S1..1stringUnique id for inter-element referencing
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code S1..1CodeableConceptinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible)
..... criteria SC1..1ExpressionThe criteria that defines this population. The alternativeExpression extension may be used to provide alternative formulations of the expression
.... stratifier S0..*BackboneElementStratifier criteria for the measure
..... id S1..1stringUnique id for inter-element referencing
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... criteria SC1..1ExpressionHow the measure should be stratified. The alternativeExpression extension may be used to provide alternative formulations of the expression
... supplementalData S0..*BackboneElementWhat other data should be reported with the measure
.... id S1..1stringUnique id for inter-element referencing
.... includeInReportType 0..*codeThe type of report the element should be included in
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType
Binding: MeasureReportType (required): The type of report the element should be included in


.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code S0..1CodeableConceptMeaning of the supplemental data
Binding: MeasureSupplementalData (preferred)
.... criteria 1..1ExpressionExpression describing additional data to be reported

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Measure.identifier:versionIndependentIdentifier.userequiredFixed Value: official
Measure.identifier:versionIndependentIdentifier.typeextensiblePattern: version-independent
Measure.identifier:versionSpecificIdentifier.userequiredFixed Value: official
Measure.identifier:versionSpecificIdentifier.typeextensiblePattern: version-specific
Measure.identifier:shortName.userequiredFixed Value: usual
Measure.identifier:shortName.typeextensiblePattern: short-name
Measure.identifier:endorserIdentifier.userequiredFixed Value: official
Measure.identifier:endorserIdentifier.typeextensiblePattern: endorser
Measure.identifier:publisherIdentifier.userequiredFixed Value: official
Measure.identifier:publisherIdentifier.typeextensiblePattern: publisher
Measure.statusrequiredFixed Value: active
Measure.jurisdictionextensibleJurisdiction ValueSet
Measure.topicexampleDefinitionTopic
Measure.relatedArtifact:predecessor.typerequiredFixed Value: predecessor
Measure.relatedArtifact:citation.typerequiredFixed Value: citation
Measure.relatedArtifact:derived-from.typerequiredFixed Value: derived-from
Measure.typeextensibleMeasureType
Measure.group.population.codeextensibleMeasurePopulationType
Measure.supplementalData.codepreferredMeasureSupplementalData

Constraints

IdGradePath(s)DetailsRequirements
cqm-2warningMeasure.libraryMeasures utilizing CQL SHALL reference one and only one CQL library (and that referenced library MUST be the primary library for the measure)
: exists()
cqm-3warningMeasure.group.idGroup identifiers SHOULD use the convention: "group-[group number]", where [group number] corresponds with the group naming convention for the criteria within the group
: startsWith('group-')
cqm-4warningMeasure.group.population.criteriaGroup population criteria SHOULD be simple expression names found within the primary library for the measure. The criteria SHOULD NOT include a namespace.
: expression.contains('.').not()
cqm-5warningMeasure.group.stratifier.criteriaGroup stratifier criteria SHOULD be simple expression names found within the primary library for the measure. The criteria SHOULD NOT include a namespace.
: expression.contains('.').not()
dom-2errorMeasureIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMeasureIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMeasureIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMeasureIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMeasureA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mea-0warningMeasureName should be usable as an identifier for the module by machine processing applications such as code generation
: name.matches('[A-Z]([A-Za-z0-9_]){0,254}')
mea-1errorMeasureStratifier SHALL be either a single criteria or a set of criteria components
: group.stratifier.all((code | description | criteria).exists() xor component.exists())

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure C1..1CQFMMeasureA quality measure definition
... id Σ0..1idLogical id of this artifact
... meta SΣ1..1MetaMetadata about the resource
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ0..1idVersion specific identifier
.... lastUpdated Σ0..1instantWhen the resource version last changed
.... source Σ0..1uriIdentifies where the resource comes from
.... profile SΣ1..*canonical(StructureDefinition)Profiles this resource claims to conform to
.... security Σ0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... tag Σ0..*CodingTags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text S1..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... comment S0..*(Complex)Additional documentation, review, or usage guidance
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-artifactComment
... softwaresystem S0..*Reference(CQFM Device)Extension
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem
... supplementalDataGuidance S0..*(Complex)Supplemental data guidance
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... url Σ1..1uriCanonical identifier for this measure, represented as a URI (globally unique)
... Slices for identifier SΣ3..*IdentifierAdditional identifier for the measure
Slice: Unordered, Open by value:type
.... identifier:versionIndependentIdentifier SΣ1..1IdentifierMeasure guid
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: official
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: version-independent
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... system SΣ1..1uriThe namespace for the identifier value
Fixed Value: urn:ietf:rfc:3986
..... value SΣ1..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:versionSpecificIdentifier SΣ1..1IdentifierMeasure version guid
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: official
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: version-specific
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... system SΣ1..1uriThe namespace for the identifier value
Fixed Value: urn:ietf:rfc:3986
..... value SΣ1..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:shortName SΣ1..1IdentifierShort name
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: usual
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: short-name
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... system Σ0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ1..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:endorserIdentifier SΣ0..*IdentifierEndorser identifier
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: official
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: endorser
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... system SΣ0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ1..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner SΣ1..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:publisherIdentifier SΣ0..*IdentifierPublisher identifier
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!SΣ1..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Fixed Value: official
..... type SΣ1..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: publisher
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... system SΣ0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ1..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner SΣ1..1Reference(Organization)Organization that issued id (may be just text)
... version Σ1..1stringBusiness version of the measure
... name ΣC1..1stringName for this measure (computer friendly)
... title SΣ1..1stringName for this measure (human friendly)
... subtitle 0..1stringSubordinate title of the measure
... status ?!Σ1..1codedraft | active | retired | unknown
Binding: PublicationStatus (required): The lifecycle status of an artifact.


Fixed Value: active
... experimental Σ1..1booleanFor testing purposes, not real usage
... subject[x] 0..1E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
Binding: SubjectType (extensible): The possible types of subjects for a measure (E.g. Patient, Practitioner, Organization, Location, etc.).

.... subjectCodeableConceptCodeableConcept
.... subjectReferenceReference(Group)
... date SΣ1..1dateTimeDate last changed
... publisher Σ1..1stringName of the publisher (organization or individual)
... contact SΣ1..*ContactDetailContact details for the publisher
... description Σ1..1markdownNatural language description of the measure
... useContext SΣ0..*UsageContextThe context that the content is intended to support
... jurisdiction SΣ0..*CodeableConceptIntended jurisdiction for measure (if applicable)
Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.


... purpose S0..1markdownWhy this measure is defined
... usage S0..1stringAllows measure developers to provide additional guidance so that implementers can more easily interpret and implement components of the measure.
... copyright S0..1markdownUse and/or publishing restrictions
... approvalDate S0..1dateWhen the measure was approved by publisher
... lastReviewDate S0..1dateWhen the measure was last reviewed
... effectivePeriod SΣ0..1PeriodWhen the measure is expected to be used
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... anchor S0..1dateTimeDate of first effective use
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodAnchor
.... duration S0..1DurationWhat reporting period is used
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectivePeriodDuration
.... start ΣC0..1dateTimeStarting time with inclusive boundary
.... end ΣC0..1dateTimeEnd time with inclusive boundary, if not ongoing
... topic S0..*CodeableConceptThe category of the measure, such as Education, Treatment, Assessment, etc.
Binding: DefinitionTopic (example): High-level categorization of the definition, used for searching, sorting, and filtering.


... author S0..*ContactDetailWho authored the content
... editor S0..*ContactDetailWho edited the content
... reviewer S0..*ContactDetailWho reviewed the content
... endorser S0..*ContactDetailWho endorsed the content
... Slices for relatedArtifact S0..*RelatedArtifactAdditional documentation, citations, etc.
Slice: Unordered, Open by value:type
.... relatedArtifact:predecessor S0..1RelatedArtifactPrevious measure?
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... type SΣ1..1codedocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Binding: RelatedArtifactType (required): The type of relationship to the related artifact.


Fixed Value: predecessor
..... label Σ0..1stringShort label
..... display Σ0..1stringBrief description of the related artifact
..... citation Σ0..1markdownBibliographic citation for the artifact
..... url Σ0..1urlWhere the artifact can be accessed
..... document Σ0..1AttachmentWhat document is being referenced
..... resource SΣ1..1canonical(Measure)What resource is being referenced
.... relatedArtifact:citation S0..*RelatedArtifactReference/citation
..... id 0..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... isPrimaryCitation 0..1booleanPrimary reference
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-isPrimaryCitation
..... publicationStatus 0..1codePublication status of referenced artifact
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-publicationStatus
Binding: PublicationStatus (required): The lifecycle status of a reference artifact


..... publicationDate 0..1datePublication date of referenced artifact
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-publicationDate
..... type SΣ1..1codedocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Binding: RelatedArtifactType (required): The type of relationship to the related artifact.


Fixed Value: citation
..... label Σ0..1stringShort label
..... display Σ0..1stringBrief description of the related artifact
..... citation Σ0..1markdownBibliographic citation for the artifact
..... url Σ0..1urlWhere the artifact can be accessed
..... document Σ0..1AttachmentWhat document is being referenced
..... resource Σ0..1canonical(Resource)What resource is being referenced
.... relatedArtifact:derived-from S0..*RelatedArtifactURL or canonical reference to other resources that a measure is derived from
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... type SΣ1..1codedocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Binding: RelatedArtifactType (required): The type of relationship to the related artifact.


Fixed Value: derived-from
..... label Σ0..1stringShort label
..... display Σ0..1stringBrief description of the related artifact
..... citation Σ0..1markdownBibliographic citation for the artifact
..... url Σ0..1urlShould be permalink otherwise include an "accessed date"
..... document Σ0..1AttachmentWhat document is being referenced
..... resource Σ0..1canonical(Measure)Should be permalink otherwise include an "accessed date"
... library SC0..1canonical(CQFM Library)CQFMMeasures are not required to use a Library, but if they do, it SHALL be a CQFMLibrary.
... disclaimer SΣ0..1markdownDisclaimer for use of the measure or its referenced content
... scoring Σ0..1CodeableConceptproportion | ratio | continuous-variable | cohort
Binding: MeasureScoring (extensible): The scoring type of the measure.

... compositeScoring Σ0..1CodeableConceptopportunity | all-or-nothing | linear | weighted
Binding: CompositeMeasureScoring (extensible): The composite scoring method of the measure.

... type SΣ0..*CodeableConceptprocess | outcome | structure | patient-reported-outcome | composite
Binding: MeasureType (extensible)
... riskAdjustment Σ0..1stringHow risk adjustment is applied for this measure
... rateAggregation Σ0..1stringHow is rate aggregation performed for this measure
... rationale Σ0..1markdownDetailed description of why the measure exists
... clinicalRecommendationStatement Σ0..1markdownSummary of clinical guidelines
... improvementNotation Σ0..1CodeableConceptincrease | decrease
Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.

... definition Σ0..*markdownDefined terms used in the measure documentation
.... id 0..1stringxml:id (or equivalent in JSON)
.... Slices for extension 1..*ExtensionExtension
Slice: Unordered, Open by value:url
.... definitionTerm 1..1(Complex)Defined term
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-definitionTerm
.... value 0..1stringPrimitive value for markdown
... group S0..*BackboneElementPopulation criteria group
.... id SC0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code 0..1CodeableConceptMeaning of the group
.... description 0..1stringSummary description
.... population S0..*BackboneElementPopulation criteria
..... id S1..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code S1..1CodeableConceptinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible)
..... description 0..1stringThe human readable description of this population criteria
..... criteria SC1..1ExpressionThe criteria that defines this population. The alternativeExpression extension may be used to provide alternative formulations of the expression
.... stratifier S0..*BackboneElementStratifier criteria for the measure
..... id S1..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... code 0..1CodeableConceptMeaning of the stratifier
..... description 0..1stringThe human readable description of this stratifier
..... criteria SC1..1ExpressionHow the measure should be stratified. The alternativeExpression extension may be used to provide alternative formulations of the expression
..... component 0..*BackboneElementStratifier criteria component for the measure
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... code 0..1CodeableConceptMeaning of the stratifier component
...... description 0..1stringThe human readable description of this stratifier component
...... criteria 1..1ExpressionComponent of how the measure should be stratified
... supplementalData S0..*BackboneElementWhat other data should be reported with the measure
.... id S1..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
.... includeInReportType 0..*codeThe type of report the element should be included in
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType
Binding: MeasureReportType (required): The type of report the element should be included in


.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code S0..1CodeableConceptMeaning of the supplemental data
Binding: MeasureSupplementalData (preferred)
.... usage 0..*CodeableConceptsupplemental-data | risk-adjustment-factor
Binding: MeasureDataUsage (preferred)
.... description 0..1stringThe human readable description of this supplemental data
.... criteria 1..1ExpressionExpression describing additional data to be reported

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Measure.meta.securityextensibleAll Security Labels
Measure.meta.tagexampleCommonTags
Measure.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Measure.identifier:versionIndependentIdentifier.userequiredFixed Value: official
Measure.identifier:versionIndependentIdentifier.typeextensiblePattern: version-independent
Measure.identifier:versionSpecificIdentifier.userequiredFixed Value: official
Measure.identifier:versionSpecificIdentifier.typeextensiblePattern: version-specific
Measure.identifier:shortName.userequiredFixed Value: usual
Measure.identifier:shortName.typeextensiblePattern: short-name
Measure.identifier:endorserIdentifier.userequiredFixed Value: official
Measure.identifier:endorserIdentifier.typeextensiblePattern: endorser
Measure.identifier:publisherIdentifier.userequiredFixed Value: official
Measure.identifier:publisherIdentifier.typeextensiblePattern: publisher
Measure.statusrequiredFixed Value: active
Measure.subject[x]extensibleSubjectType
Measure.jurisdictionextensibleJurisdiction ValueSet
Measure.topicexampleDefinitionTopic
Measure.relatedArtifact:predecessor.typerequiredFixed Value: predecessor
Measure.relatedArtifact:citation.typerequiredFixed Value: citation
Measure.relatedArtifact:derived-from.typerequiredFixed Value: derived-from
Measure.scoringextensibleMeasureScoring
Measure.compositeScoringextensibleCompositeMeasureScoring
Measure.typeextensibleMeasureType
Measure.improvementNotationrequiredMeasureImprovementNotation
Measure.group.population.codeextensibleMeasurePopulationType
Measure.supplementalData.codepreferredMeasureSupplementalData
Measure.supplementalData.usagepreferredMeasureDataUsage

Constraints

IdGradePath(s)DetailsRequirements
cqm-2warningMeasure.libraryMeasures utilizing CQL SHALL reference one and only one CQL library (and that referenced library MUST be the primary library for the measure)
: exists()
cqm-3warningMeasure.group.idGroup identifiers SHOULD use the convention: "group-[group number]", where [group number] corresponds with the group naming convention for the criteria within the group
: startsWith('group-')
cqm-4warningMeasure.group.population.criteriaGroup population criteria SHOULD be simple expression names found within the primary library for the measure. The criteria SHOULD NOT include a namespace.
: expression.contains('.').not()
cqm-5warningMeasure.group.stratifier.criteriaGroup stratifier criteria SHOULD be simple expression names found within the primary library for the measure. The criteria SHOULD NOT include a namespace.
: expression.contains('.').not()
dom-2errorMeasureIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMeasureIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMeasureIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMeasureIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMeasureA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mea-0warningMeasureName should be usable as an identifier for the module by machine processing applications such as code generation
: name.matches('[A-Z]([A-Za-z0-9_]){0,254}')
mea-1errorMeasureStratifier SHALL be either a single criteria or a set of criteria components
: group.stratifier.all((code | description | criteria).exists() xor component.exists())

This structure is derived from CQFMMeasure

Summary

Mandatory: 20 elements (13 nested mandatory elements)
Must-Support: 54 elements
Fixed Value: 11 elements
Prohibited: 1 element

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Measure.identifier is sliced based on the value of value:type
  • The element Measure.relatedArtifact is sliced based on the value of value:type

 

Other representations of profile: CSV, Excel, Schematron