Quality Measure Implementation Guide
2.0.0-ballot - STU 2 Ballot

Quality Measure Implementation Guide - Downloaded Version null See the Directory of published versions

## Resource Profile: CQM Ratio Measure - Detailed Descriptions

Page standards status: Trial-use | Maturity Level: 4

Definitions for the cqm-ratiomeasure resource profile

- Key Elements Table
- Differential Table
- Snapshot Table

Guidance on how to interpret the contents of this table can be foundhere

0. Measure
Definition | The Measure resource provides the definition of a quality measure.
Short | A quality measure definition
Control | 0..*
Is Modifier | false
Must Support | true
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (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-4: If 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) mea-0: Name 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-1: Stratifier SHALL be either a single criteria or a set of criteria components (`group.stratifier.all((code | description | criteria).exists() xor component.exists())`) comp-1: Population basis must be specified at the root, or on each group (`extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists() or group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists()).allTrue()`) comp-2: Scoring is required. It must be specified on the root only, or on every group, and it cannot be on both. (`(scoring.exists() and group.extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').empty()) xor (scoring.empty() and group.all(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()))`) comp-3: Scoring unit may only be specified at the root if the scoring is also specified at the root (`extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies scoring.exists()`) comp-4: If scoring is specified on the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required on the root. (`scoring.exists() and (scoring.coding.code in ('proportion' | 'ratio' | 'continuous-variable')) implies improvementNotation.exists()`) comp-5: If type is specified at the root, it may not be specified on any group (`type.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type').exists()).allFalse()`) comp-6: If riskAdjustment is specified at the root, it may not be specified on any group (`riskAdjustment.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment').exists()).allFalse()`) comp-7: If rateAggregation is specified at the root, it may not be specified on any group (`rateAggregation.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation').exists()).allFalse()`) mea-0: Name 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-1: Stratifier SHALL be either a single criteria or a set of criteria components (group.stratifier.all((code | description | criteria).exists() xor component.exists()))
2. Measure.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Measure.extension:populationBasis
Slice Name | populationBasis
Definition | The population basis specifies the type of elements in the population. For a subject-based measure, this is boolean (because the subject and the population basis are the same, and the population criteria define yes/no values for each individual in the population). For measures that have a population basis that is different than the subject, this element specifies the type of the population basis. For example, an encounter-based measure has a subject of Patient and a population basis of Encounter, and the population criteria all return lists of Encounters.
Short | What type of population
Comments | In Health Quality Measure Format, this was referred to as the Item Count metadata attribute. If the populationBasis is specified as a data requirement, the type SHALL be present, profile and codeFilter MAY be present, and no other elements are allowed. This usage allows population basis to be stated with more specificity, e.g. CT Scans, rather than just DiagnosticReport.
Control | 0..* This element is affected by the following invariants: ele-1, comp-1
Type | Extension(CQM Population Basis) (Extension Type: Choice of: code, DataRequirement)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) popBasis-1: If DataRequirement.type is present, it may only contain the elements 'profile' and 'codeFilter'. (`value.exists() and value.is(DataRequirement) implies ( value.as(DataRequirement).type.exists() and value.as(DataRequirement).limit.empty() and value.as(DataRequirement).sort.empty() and value.as(DataRequirement).dateFilter.empty() and value.as(DataRequirement).subject.empty() and value.as(DataRequirement).mustSupport.empty())`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Measure.extension:scoringUnit
Slice Name | scoringUnit
Definition | Defines the expected units of measure for the measure score.
Short | What units?
Control | 0..1 This element is affected by the following invariants: ele-1, comp-3
Type | Extension(CQM Scoring Unit) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Measure.extension:effectiveDataRequirements
Slice Name | effectiveDataRequirements
Definition | A module definition library that contains the effective data requirements for the artifact (i.e. the calculated data requirements for the expressions referenced by the artifact structure).
Short | Effective required data for evaluation
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CRMI Effective Data Requirements) (Extension Type: canonical(CRMI Module Definition Library))
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. Measure.extension:scoringPrecision
Slice Name | scoringPrecision
Definition | Defines the precision of the measure score when it is a decimal value.
Short | Number of decimal places
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Scoring Precision) (Extension Type: positiveInt)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. Measure.extension:reportingTiming
Slice Name | reportingTiming
Definition | Specifies when the measure should be reported as a Timing data type
Short | When and how often the measure should be reported
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Reporting Timing) (Extension Type: Timing(CQM DataType Timing))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. Measure.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
16. Measure.status
Definition | The status of this measure. Enables tracking the life-cycle of the content.
Short | draft | active | retired | unknown
Comments | Allows filtering of measures that are appropriate for use versus not.
Control | 1..1
Binding | The codes SHALL be taken from PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/publication-status|4.0.1` ) The lifecycle status of an artifact.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Measure.subject[x]
Definition | The intended subjects for the measure. If this element is not provided, a Patient subject is assumed, but the subject of the measure can be anything.
Short | E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
Comments | The subject of the measure is critical in interpreting the criteria definitions, as the logic in the measures is evaluated with respect to a particular subject. This corresponds roughly to the notion of a Compartment in that it limits what content is available based on its relationship to the subject. In CQL, this corresponds to the context declaration.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from Subject Type Value Set http://hl7.org/fhir/ValueSet/subject-type|4.0.1 (extensible to `http://hl7.org/fhir/uv/cqm/ValueSet/subject-type` )
Type | Choice of: CodeableConcept, Reference(Group)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Meaning if Missing | Patient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Measure.usage
Definition | A detailed description, from a clinical perspective, of how the measure is used.
Short | Describes the clinical usage of the measure
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Measure.library
Definition | A reference to a Library resource containing the formal logic used by the measure.
Short | Logic used by the measure
Control | 0..1*
Type | canonical(CRMI Computable Library, Library)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Measure.scoring
Definition | Indicates how the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort. The value set is extensible, allowing additional measure scoring types to be represented.
Short | ratioproportion | ratio | continuous-variable | cohort
Control | 0..1 This element is affected by the following invariants: comp-2, comp-3, comp-4
Binding | Unless not suitable, these codes SHALL be taken from Measure Scoring http://hl7.org/fhir/ValueSet/measure-scoring|4.0.1 (extensible to `http://terminology.hl7.org/ValueSet/measure-scoring` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring", "code" : "ratio" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. Measure.type
Definition | Indicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilization.
Short | Indicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilization.process | outcome | structure | patient-reported-outcome | composite
Control | 0..* This element is affected by the following invariants: comp-5
Binding | Unless not suitable, these codes SHALL be taken from ObservationMeasureType http://hl7.org/fhir/ValueSet/measure-type|4.0.1 (extensible to `http://terminology.hl7.org/ValueSet/v3-ObservationMeasureType` ) Indicates the type of quality measure based on the observation value. The type of measure (includes codes from 2.16.840.1.113883.1.11.20368).
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Measure.improvementNotation
Definition | Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range).
Short | increase | decrease
Control | 0..1 This element is affected by the following invariants: comp-4
Binding | The codes SHALL be taken from MeasureImprovementNotation http://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.1 (required to `http://terminology.hl7.org/ValueSet/measure-improvement-notation` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Measure consumers and implementers must be able to determine how to interpret a measure score.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Measure.group
Definition | A group of population criteria for the measure.
Short | Population criteria group
Control | 10..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) comp-8: Scoring unit may only be specified at the root if the scoring is also specified at the root (`extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()`) comp-9: If scoring is specified on the group and the scoring type is 'proportion', 'ratio', or 'continuous-variable' then the improvementNotation element is required. (`extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable') implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation').exists()`) cmp-13: Ratio measures may not have other than initial population, denominator, numerator, denominator-exclusion, numerator-exclusion, and measure-observation criteria (`extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'ratio' implies population.select(code.coding.where(system = 'http://terminology.hl7.org/CodeSystem/measure-population').code in ('initial-population' | 'numerator' | 'denominator' | 'denominator-exclusion' | 'measure-observation' | 'numerator-exclusion')).allTrue()`)
32. Measure.group.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Measure.group.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
34. Measure.group.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the group
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
36. Measure.group.extension:populationBasis
Slice Name | populationBasis
Definition | The population basis specifies the type of elements in the population. For a subject-based measure, this is boolean (because the subject and the population basis are the same, and the population criteria define yes/no values for each individual in the population). For measures that have a population basis that is different than the subject, this element specifies the type of the population basis. For example, an encounter-based measure has a subject of Patient and a population basis of Encounter, and the population criteria all return lists of Encounters.
Short | What type of population
Comments | In Health Quality Measure Format, this was referred to as the Item Count metadata attribute. If the populationBasis is specified as a data requirement, the type SHALL be present, profile and codeFilter MAY be present, and no other elements are allowed. This usage allows population basis to be stated with more specificity, e.g. CT Scans, rather than just DiagnosticReport.
Control | 0..1 This element is affected by the following invariants: ele-1, comp-1
Type | Extension(CQM Population Basis) (Extension Type: Choice of: code, DataRequirement)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) popBasis-1: If DataRequirement.type is present, it may only contain the elements 'profile' and 'codeFilter'. (`value.exists() and value.is(DataRequirement) implies ( value.as(DataRequirement).type.exists() and value.as(DataRequirement).limit.empty() and value.as(DataRequirement).sort.empty() and value.as(DataRequirement).dateFilter.empty() and value.as(DataRequirement).subject.empty() and value.as(DataRequirement).mustSupport.empty())`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
38. Measure.group.extension:scoring
Slice Name | scoring
Definition | Indicates how the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort. The value set is extensible, allowing additional measure scoring types to be represented. When present on a group, specifies the scoring to be used for this group, overriding the scoring specified for the overall measure.
Short | proportion | ratio | continuous-variable | cohort
Control | 0..1 This element is affected by the following invariants: ele-1, comp-2, comp-8, comp-9, cmp-13
Type | Extension(CQM Scoring) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
40. Measure.group.extension:scoringUnit
Slice Name | scoringUnit
Definition | Defines the expected units of measure for the measure score.
Short | What units?
Control | 0..1 This element is affected by the following invariants: ele-1, comp-8
Type | Extension(CQM Scoring Unit) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
42. Measure.group.extension:scoringPrecision
Slice Name | scoringPrecision
Definition | Defines the precision of the measure score when it is a decimal value.
Short | Number of decimal places
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Scoring Precision) (Extension Type: positiveInt)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
44. Measure.group.extension:compositeScoring
Slice Name | compositeScoring
Definition | Indicates how the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort. The value set is extensible, allowing additional measure scoring types to be represented. When present on a group, specifies the scoring to be used for this group, overriding the scoring specified for the overall measure.
Short | proportion | ratio | continuous-variable | cohort
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Composite Scoring) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
46. Measure.group.extension:component
Slice Name | component
Definition | Specifies an artifact this is a component of a composite artifact.
Short | What artifact
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(CQM Component) (Extension Type: RelatedArtifact)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
48. Measure.group.extension:type
Slice Name | type
Definition | Indicates the type of quality measure based on the observation value.
Short | Extension
Control | 0..* This element is affected by the following invariants: ele-1, comp-5
Type | Extension(CQM Type) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
50. Measure.group.extension:riskAdjustment
Slice Name | riskAdjustment
Definition | A description of the risk adjustment factors that may impact the resulting score for the measure and how they may be accounted for when computing and reporting measure results.
Short | How risk adjustment is applied for this measure
Comments | Describes the method of adjusting for clinical severity and conditions present at the start of care that can influence patient outcomes for making valid comparisons of outcome measures across providers. Indicates whether a measure is subject to the statistical process for reducing, removing, or clarifying the influences of confounding factors to allow for more useful comparisons.
Control | 0..1 This element is affected by the following invariants: ele-1, comp-6
Type | Extension(CQM Risk Adjustment) (Extension Type: string)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
52. Measure.group.extension:rateAggregation
Slice Name | rateAggregation
Definition | Describes how to combine the information calculated, based on logic in each of several populations, into one summarized result.
Short | How is rate aggregation performed for this measure
Comments | The measure rate for an organization or clinician is based upon the entities’ aggregate data and summarizes the performance of the entity over a given time period (e.g., monthly, quarterly, yearly). The aggregated data are derived from the results of a specific measure algorithm and, if appropriate, the application of specific risk adjustment models. Can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure (e.g., pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two). This could be applied to aggregated cohort measure definitions (e.g., CDC's aggregate reporting for TB at the state level).
Control | 0..1 This element is affected by the following invariants: ele-1, comp-7
Type | Extension(CQM Rate Aggregation) (Extension Type: string)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
54. Measure.group.extension:improvementNotation
Slice Name | improvementNotation
Definition | Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range).
Short | increase | decrease
Control | 0..1 This element is affected by the following invariants: ele-1, comp-9
Type | Extension(CQM Improvement Notation) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
56. Measure.group.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
58. Measure.group.code
Definition | Indicates a meaning for the group. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing groups to be correlated across measures.
Short | Meaning of the group
Control | 0..1
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. Measure.group.description
Definition | The human readable description of this population group.
Short | Summary description
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. Measure.group.population
Definition | A population criteria for the measure.
Short | Population criteria
Control | 40..8* This element is affected by the following invariants: cmp-13
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Measure.group.population`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ code
64. Measure.group.population.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Measure.group.population.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
66. Measure.group.population.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the population
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.population.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
68. Measure.group.population.extension:supportingEvidenceDefinition
Slice Name | supportingEvidenceDefinition
Definition | An Extension
Short | Extension
Control | 0..1
Type | Extension(`http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition`)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
70. Measure.group.population.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
72. Measure.group.population.code
Definition | The type of population criteria.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType http://hl7.org/fhir/ValueSet/measure-population|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/measure-population|4.0.1` ) The type of population.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. Measure.group.population.description
Definition | The human readable description of this population criteria.
Short | The human readable description of this population criteria
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
76. Measure.group.population.criteria
Definition | An expression that specifies the criteria for the population, typically the name of an expression in a library.
Short | The criteria that defines this population
Comments | In the case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
78. Measure.group.population:initialPopulation
Slice Name | initialPopulation
Definition | A population criteria for the measure.
Short | Initial PopulationPopulation criteria
Control | 10..2*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
80. Measure.group.population:initialPopulation.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Measure.group.population.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
82. Measure.group.population:initialPopulation.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the population
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.population.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
84. Measure.group.population:initialPopulation.extension:supportingEvidenceDefinition
Slice Name | supportingEvidenceDefinition
Definition | An Extension
Short | Extension
Control | 0..1
Type | Extension(`http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition`)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
86. Measure.group.population:initialPopulation.extension:populationBasis
Slice Name | populationBasis
Definition | The population basis specifies the type of elements in the population. For a subject-based measure, this is boolean (because the subject and the population basis are the same, and the population criteria define yes/no values for each individual in the population). For measures that have a population basis that is different than the subject, this element specifies the type of the population basis. For example, an encounter-based measure has a subject of Patient and a population basis of Encounter, and the population criteria all return lists of Encounters.
Short | Allows the populationBasis for that population to be overridden. If not present, the populationBasis of the measure (or group) is used. If present, it specifies the population basis for all the expressions that use it as the initial population in the ratio measure.
Comments | In Health Quality Measure Format, this was referred to as the Item Count metadata attribute. If the populationBasis is specified as a data requirement, the type SHALL be present, profile and codeFilter MAY be present, and no other elements are allowed. This usage allows population basis to be stated with more specificity, e.g. CT Scans, rather than just DiagnosticReport.
Control | 0..*
Type | Extension(CQM Population Basis) (Extension Type: Choice of: code, DataRequirement)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
88. Measure.group.population:initialPopulation.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
90. Measure.group.population:initialPopulation.code
Definition | The type of population criteria.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType http://hl7.org/fhir/ValueSet/measure-population|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/measure-population|4.0.1` ) The type of population.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "initial-population" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
92. Measure.group.population:initialPopulation.description
Definition | The human readable description of this population criteria.
Short | The human readable description of this population criteria
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
94. Measure.group.population:initialPopulation.criteria
Definition | An expression that specifies the criteria for the population, typically the name of an expression in a library.
Short | The criteria that defines this population
Comments | In the case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
96. Measure.group.population:denominator
Slice Name | denominator
Definition | A population criteria for the measure.
Short | DenominatorPopulation criteria
Control | 10..1*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
98. Measure.group.population:denominator.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Measure.group.population.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
100. Measure.group.population:denominator.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the population
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.population.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
102. Measure.group.population:denominator.extension:supportingEvidenceDefinition
Slice Name | supportingEvidenceDefinition
Definition | An Extension
Short | Extension
Control | 0..1
Type | Extension(`http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition`)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
104. Measure.group.population:denominator.extension:criteriaReference
Slice Name | criteriaReference
Definition | Reference a criteria by specifying that criteria's unique id
Short | Criteria reference
Comments | When used in a MeasureReport, this is a reference to the id of a criteria within the Measure referenced by the MeasureReport.
Control | 0..1
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
106. Measure.group.population:denominator.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
108. Measure.group.population:denominator.code
Definition | The type of population criteria.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType http://hl7.org/fhir/ValueSet/measure-population|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/measure-population|4.0.1` ) The type of population.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "denominator" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
110. Measure.group.population:denominator.description
Definition | The human readable description of this population criteria.
Short | The human readable description of this population criteria
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
112. Measure.group.population:denominator.criteria
Definition | An expression that specifies the criteria for the population, typically the name of an expression in a library.
Short | The criteria that defines this population
Comments | In the case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
114. Measure.group.population:denominatorExclusion
Slice Name | denominatorExclusion
Definition | A population criteria for the measure.
Short | Denominator ExclusionPopulation criteria
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
116. Measure.group.population:denominatorExclusion.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Measure.group.population.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
118. Measure.group.population:denominatorExclusion.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the population
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.population.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
120. Measure.group.population:denominatorExclusion.extension:supportingEvidenceDefinition
Slice Name | supportingEvidenceDefinition
Definition | An Extension
Short | Extension
Control | 0..1
Type | Extension(`http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition`)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
122. Measure.group.population:denominatorExclusion.extension:criteriaReference
Slice Name | criteriaReference
Definition | Reference a criteria by specifying that criteria's unique id
Short | Criteria reference
Comments | When used in a MeasureReport, this is a reference to the id of a criteria within the Measure referenced by the MeasureReport.
Control | 0..1
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
124. Measure.group.population:denominatorExclusion.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
126. Measure.group.population:denominatorExclusion.code
Definition | The type of population criteria.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType http://hl7.org/fhir/ValueSet/measure-population|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/measure-population|4.0.1` ) The type of population.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "denominator-exclusion" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
128. Measure.group.population:denominatorExclusion.description
Definition | The human readable description of this population criteria.
Short | The human readable description of this population criteria
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
130. Measure.group.population:denominatorExclusion.criteria
Definition | An expression that specifies the criteria for the population, typically the name of an expression in a library.
Short | The criteria that defines this population
Comments | In the case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
132. Measure.group.population:numerator
Slice Name | numerator
Definition | A population criteria for the measure.
Short | NumeratorPopulation criteria
Control | 10..1*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
134. Measure.group.population:numerator.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Measure.group.population.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
136. Measure.group.population:numerator.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the population
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.population.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
138. Measure.group.population:numerator.extension:supportingEvidenceDefinition
Slice Name | supportingEvidenceDefinition
Definition | An Extension
Short | Extension
Control | 0..1
Type | Extension(`http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition`)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
140. Measure.group.population:numerator.extension:criteriaReference
Slice Name | criteriaReference
Definition | Reference a criteria by specifying that criteria's unique id
Short | Criteria reference
Comments | When used in a MeasureReport, this is a reference to the id of a criteria within the Measure referenced by the MeasureReport.
Control | 0..1
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
142. Measure.group.population:numerator.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
144. Measure.group.population:numerator.code
Definition | The type of population criteria.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType http://hl7.org/fhir/ValueSet/measure-population|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/measure-population|4.0.1` ) The type of population.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "numerator" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
146. Measure.group.population:numerator.description
Definition | The human readable description of this population criteria.
Short | The human readable description of this population criteria
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
148. Measure.group.population:numerator.criteria
Definition | An expression that specifies the criteria for the population, typically the name of an expression in a library.
Short | The criteria that defines this population
Comments | In the case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
150. Measure.group.population:numeratorExclusion
Slice Name | numeratorExclusion
Definition | A population criteria for the measure.
Short | Numerator ExclusionPopulation criteria
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
152. Measure.group.population:numeratorExclusion.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Measure.group.population.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
154. Measure.group.population:numeratorExclusion.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the population
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.population.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
156. Measure.group.population:numeratorExclusion.extension:supportingEvidenceDefinition
Slice Name | supportingEvidenceDefinition
Definition | An Extension
Short | Extension
Control | 0..1
Type | Extension(`http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition`)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
158. Measure.group.population:numeratorExclusion.extension:criteriaReference
Slice Name | criteriaReference
Definition | Reference a criteria by specifying that criteria's unique id
Short | Criteria reference
Comments | When used in a MeasureReport, this is a reference to the id of a criteria within the Measure referenced by the MeasureReport.
Control | 0..1
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
160. Measure.group.population:numeratorExclusion.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
162. Measure.group.population:numeratorExclusion.code
Definition | The type of population criteria.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType http://hl7.org/fhir/ValueSet/measure-population|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/measure-population|4.0.1` ) The type of population.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "numerator-exclusion" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
164. Measure.group.population:numeratorExclusion.description
Definition | The human readable description of this population criteria.
Short | The human readable description of this population criteria
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
166. Measure.group.population:numeratorExclusion.criteria
Definition | An expression that specifies the criteria for the population, typically the name of an expression in a library.
Short | The criteria that defines this population
Comments | In the case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
168. Measure.group.population:measureObservation
Slice Name | measureObservation
Definition | A population criteria for the measure.
Short | Measure ObservationPopulation criteria
Control | 0..2*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
170. Measure.group.population:measureObservation.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 20..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Measure.group.population.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
172. Measure.group.population:measureObservation.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the population
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.population.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
174. Measure.group.population:measureObservation.extension:supportingEvidenceDefinition
Slice Name | supportingEvidenceDefinition
Definition | An Extension
Short | Extension
Control | 0..1
Type | Extension(`http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition`)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
176. Measure.group.population:measureObservation.extension:criteriaReference
Slice Name | criteriaReference
Definition | Reference a criteria by specifying that criteria's unique id
Short | Criteria reference
Comments | When used in a MeasureReport, this is a reference to the id of a criteria within the Measure referenced by the MeasureReport.
Control | 0..1
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
178. Measure.group.population:measureObservation.extension:aggregateMethod
Slice Name | aggregateMethod
Definition | Specifies which method to be used to aggregate the measure observation values.
Short | Aggregate with
Control | 1..1
Type | Extension(CQM Aggregate Method) (Extension Type: code)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
180. Measure.group.population:measureObservation.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
182. Measure.group.population:measureObservation.code
Definition | The type of population criteria.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType http://hl7.org/fhir/ValueSet/measure-population|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/measure-population|4.0.1` ) The type of population.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "measure-observation" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
184. Measure.group.population:measureObservation.description
Definition | The human readable description of this population criteria.
Short | The human readable description of this population criteria
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
186. Measure.group.population:measureObservation.criteria
Definition | An expression that specifies the criteria for the population, typically the name of an expression in a library.
Short | The criteria that defines this population
Comments | In the case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
188. Measure.group.stratifier
Definition | The stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library or a valid FHIR Resource Path.
Short | Stratifier criteria for the measure
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
190. Measure.group.stratifier.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Measure.group.stratifier.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
192. Measure.group.stratifier.extension:appliesTo
Slice Name | appliesTo
Definition | Indicates the population that this stratifier should apply to. If no appliesTo extension is present, the stratifier is calculated based on the result of the population calculation (e.g. the calculated numerator for a proportion scoring).
Short | Which population does this stratifier apply to?
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(CQM Applies To) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
194. Measure.group.stratifier.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the stratifier
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.stratifier.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
196. Measure.group.stratifier.extension:valueSet
Slice Name | valueSet
Definition | A value set defining the set of possible values for stratum in this stratifier. If criteria and valueSet are both present, they SHALL be consistent (i.e. criteria expressions SHALL produce stratum values that are codes in the value set referenced by this element). Note that this MAY be strictly at the code level (e.g. an Age Range code that is just the string value 01Y--05Y with the system ignored).
Short | What stratum values?
Comments | This element may be used to define a stratifier rather than requiring the stratifier be defined with logic. For example, a measure may reference a value set defining possible age ranges, rather than (and potentially in addition to) embedding the calculation of the age ranges into measure logic. See the MeasureStratifierAgeRangeExample value set for an example. If present, the value set SHALL be consistent with the criteria (i.e., the criteria, when evaluated, will result in values from the value set).
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Value Set) (Extension Type: canonical)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
198. Measure.group.stratifier.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
200. Measure.group.stratifier.code
Definition | Indicates a meaning for the stratifier. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing stratifiers to be correlated across measures.
Short | Meaning of the stratifier
Control | 0..1
Binding | The codes SHOULD be taken from For codes, see Measure Stratifier Type (preferred to `http://terminology.hl7.org/ValueSet/measure-stratifier-type` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
202. Measure.group.stratifier.description
Definition | The human readable description of this stratifier criteria.
Short | The human readable description of this stratifier
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
204. Measure.group.stratifier.component
Definition | A component of the stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library or a valid FHIR Resource Path.
Short | Stratifier criteria component for the measure
Comments | Stratifiers are defined either as a single criteria, or as a set of component criteria.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
206. Measure.group.stratifier.component.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Measure.group.stratifier.component.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
208. Measure.group.stratifier.component.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the stratifier component
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.stratifier.component.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
210. Measure.group.stratifier.component.extension:valueSet
Slice Name | valueSet
Definition | A value set defining the set of possible values for stratum in this stratifier. If criteria and valueSet are both present, they SHALL be consistent (i.e. criteria expressions SHALL produce stratum values that are codes in the value set referenced by this element). Note that this MAY be strictly at the code level (e.g. an Age Range code that is just the string value 01Y--05Y with the system ignored).
Short | What stratum values?
Comments | This element may be used to define a stratifier rather than requiring the stratifier be defined with logic. For example, a measure may reference a value set defining possible age ranges, rather than (and potentially in addition to) embedding the calculation of the age ranges into measure logic. See the MeasureStratifierAgeRangeExample value set for an example. If present, the value set SHALL be consistent with the criteria (i.e., the criteria, when evaluated, will result in values from the value set).
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Value Set) (Extension Type: canonical)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
212. Measure.group.stratifier.component.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
214. Measure.group.stratifier.component.code
Definition | Indicates a meaning for the stratifier component. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing stratifiers to be correlated across measures.
Short | Meaning of the stratifier component
Control | 0..1
Binding | The codes SHOULD be taken from For codes, see Measure Stratifier Type (preferred to `http://terminology.hl7.org/ValueSet/measure-stratifier-type` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
216. Measure.group.stratifier.component.description
Definition | The human readable description of this stratifier criteria component.
Short | The human readable description of this stratifier component
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
218. Measure.group.stratifier.component.criteria
Definition | An expression that specifies the criteria for this component of the stratifier. This is typically the name of an expression defined within a referenced library, but it may also be a path to a stratifier element.
Short | Component of how the measure should be stratified
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
220. Measure.supplementalData
Definition | The supplemental data criteria for the measure report, specified as either the name of a valid CQL expression within a referenced library, or a valid FHIR Resource Path.
Short | What other data should be reported with the measure
Comments | Note that supplemental data are reported as observations for each patient and included in the evaluatedResources bundle. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
222. Measure.supplementalData.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Measure.supplementalData.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
224. Measure.supplementalData.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the supplemental data
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.supplementalData.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
226. Measure.supplementalData.extension:valueSet
Slice Name | valueSet
Definition | A value set defining the set of possible values for stratum in this stratifier. If criteria and valueSet are both present, they SHALL be consistent (i.e. criteria expressions SHALL produce stratum values that are codes in the value set referenced by this element). Note that this MAY be strictly at the code level (e.g. an Age Range code that is just the string value 01Y--05Y with the system ignored).
Short | What stratum values?
Comments | This element may be used to define a stratifier rather than requiring the stratifier be defined with logic. For example, a measure may reference a value set defining possible age ranges, rather than (and potentially in addition to) embedding the calculation of the age ranges into measure logic. See the MeasureStratifierAgeRangeExample value set for an example. If present, the value set SHALL be consistent with the criteria (i.e., the criteria, when evaluated, will result in values from the value set).
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Value Set) (Extension Type: canonical)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
228. Measure.supplementalData.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
230. Measure.supplementalData.code
Definition | Indicates a meaning for the supplemental data. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing supplemental data to be correlated across measures.
Short | Meaning of the supplemental data
Control | 0..1
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
232. Measure.supplementalData.usage
Definition | An indicator of the intended usage for the supplemental data element. Supplemental data indicates the data is additional information requested to augment the measure information. Risk adjustment factor indicates the data is additional information used to calculate risk adjustment factors when applying a risk model to the measure calculation.
Short | supplemental-data | risk-adjustment-factor
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from MeasureDataUsage http://hl7.org/fhir/ValueSet/measure-data-usage|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/measure-data-usage|4.0.1` ) The intended usage for supplemental data elements in the measure.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
234. Measure.supplementalData.description
Definition | The human readable description of this supplemental data.
Short | The human readable description of this supplemental data
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
236. Measure.supplementalData.criteria
Definition | The criteria for the supplemental data. This is typically the name of a valid expression defined within a referenced library, but it may also be a path to a specific data element. The criteria defines the data to be returned for this element.
Short | Expression describing additional data to be reported
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be foundhere

0. Measure
2. Measure.scoring
Short | ratio
Type | CodeableConcept
Must Support | true
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring", "code" : "ratio" }] }`
4. Measure.group
Control | 1..*
Must Support | true
Invariants | cmp-13: Ratio measures may not have other than initial population, denominator, numerator, denominator-exclusion, numerator-exclusion, and measure-observation criteria (`extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'ratio' implies population.select(code.coding.where(system = 'http://terminology.hl7.org/CodeSystem/measure-population').code in ('initial-population' | 'numerator' | 'denominator' | 'denominator-exclusion' | 'measure-observation' | 'numerator-exclusion')).allTrue()`)
6. Measure.group.extension:scoring
Slice Name | scoring
Control | 0..1 This element is affected by the following invariants: cmp-13, ele-1, comp-2, comp-8, comp-9
Type | Extension(CQM Scoring) (Extension Type: CodeableConcept)
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Measure.group.population
Control | 4..8 This element is affected by the following invariants: cmp-13
Must Support | true
Slicing | This element introduces a set of slices on `Measure.group.population`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ code
10. Measure.group.population:initialPopulation
Slice Name | initialPopulation
Short | Initial Population
Control | 1..2
Must Support | true
12. Measure.group.population:initialPopulation.extension:populationBasis
Slice Name | populationBasis
Short | Allows the populationBasis for that population to be overridden. If not present, the populationBasis of the measure (or group) is used. If present, it specifies the population basis for all the expressions that use it as the initial population in the ratio measure.
Control | 0..*
Type | Extension(CQM Population Basis) (Extension Type: Choice of: code, DataRequirement)
Must Support | false
14. Measure.group.population:initialPopulation.code
Control | 1..1
Type | CodeableConcept
Must Support | true
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "initial-population" }] }`
16. Measure.group.population:denominator
Slice Name | denominator
Short | Denominator
Control | 1..1
Must Support | true
18. Measure.group.population:denominator.extension:criteriaReference
Slice Name | criteriaReference
Control | 0..1
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Must Support | true
20. Measure.group.population:denominator.code
Control | 1..1
Type | CodeableConcept
Must Support | true
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "denominator" }] }`
22. Measure.group.population:denominatorExclusion
Slice Name | denominatorExclusion
Short | Denominator Exclusion
Control | 0..1
Must Support | true
24. Measure.group.population:denominatorExclusion.extension:criteriaReference
Slice Name | criteriaReference
Control | 0..1
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Must Support | true
26. Measure.group.population:denominatorExclusion.code
Control | 1..1
Type | CodeableConcept
Must Support | true
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "denominator-exclusion" }] }`
28. Measure.group.population:numerator
Slice Name | numerator
Short | Numerator
Control | 1..1
Must Support | true
30. Measure.group.population:numerator.extension:criteriaReference
Slice Name | criteriaReference
Control | 0..1
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Must Support | true
32. Measure.group.population:numerator.code
Control | 1..1
Type | CodeableConcept
Must Support | true
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "numerator" }] }`
34. Measure.group.population:numeratorExclusion
Slice Name | numeratorExclusion
Short | Numerator Exclusion
Control | 0..1
Must Support | true
36. Measure.group.population:numeratorExclusion.extension:criteriaReference
Slice Name | criteriaReference
Control | 0..1
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Must Support | true
38. Measure.group.population:numeratorExclusion.code
Control | 1..1
Type | CodeableConcept
Must Support | true
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "numerator-exclusion" }] }`
40. Measure.group.population:measureObservation
Slice Name | measureObservation
Short | Measure Observation
Control | 0..2
Must Support | true
42. Measure.group.population:measureObservation.extension:criteriaReference
Slice Name | criteriaReference
Control | 0..1
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Must Support | true
44. Measure.group.population:measureObservation.extension:aggregateMethod
Slice Name | aggregateMethod
Control | 1..1
Type | Extension(CQM Aggregate Method) (Extension Type: code)
Must Support | true
46. Measure.group.population:measureObservation.code
Control | 1..1
Type | CodeableConcept
Must Support | true
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "measure-observation" }] }`

Guidance on how to interpret the contents of this table can be foundhere

0. Measure
Definition | The Measure resource provides the definition of a quality measure.
Short | A quality measure definition
Control | 0..*
Is Modifier | false
Must Support | true
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (`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-4: If 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`) mea-0: Name 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-1: Stratifier SHALL be either a single criteria or a set of criteria components (`group.stratifier.all((code | description | criteria).exists() xor component.exists())`) comp-1: Population basis must be specified at the root, or on each group (`extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists() or group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists()).allTrue()`) comp-2: Scoring is required. It must be specified on the root only, or on every group, and it cannot be on both. (`(scoring.exists() and group.extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').empty()) xor (scoring.empty() and group.all(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()))`) comp-3: Scoring unit may only be specified at the root if the scoring is also specified at the root (`extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies scoring.exists()`) comp-4: If scoring is specified on the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required on the root. (`scoring.exists() and (scoring.coding.code in ('proportion' | 'ratio' | 'continuous-variable')) implies improvementNotation.exists()`) comp-5: If type is specified at the root, it may not be specified on any group (`type.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type').exists()).allFalse()`) comp-6: If riskAdjustment is specified at the root, it may not be specified on any group (`riskAdjustment.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment').exists()).allFalse()`) comp-7: If rateAggregation is specified at the root, it may not be specified on any group (`rateAggregation.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation').exists()).allFalse()`)
2. Measure.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. Measure.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. Measure.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. Measure.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. Measure.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. Measure.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. Measure.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. Measure.extension:populationBasis
Slice Name | populationBasis
Definition | The population basis specifies the type of elements in the population. For a subject-based measure, this is boolean (because the subject and the population basis are the same, and the population criteria define yes/no values for each individual in the population). For measures that have a population basis that is different than the subject, this element specifies the type of the population basis. For example, an encounter-based measure has a subject of Patient and a population basis of Encounter, and the population criteria all return lists of Encounters.
Short | What type of population
Comments | In Health Quality Measure Format, this was referred to as the Item Count metadata attribute. If the populationBasis is specified as a data requirement, the type SHALL be present, profile and codeFilter MAY be present, and no other elements are allowed. This usage allows population basis to be stated with more specificity, e.g. CT Scans, rather than just DiagnosticReport.
Control | 0..* This element is affected by the following invariants: ele-1, comp-1
Type | Extension(CQM Population Basis) (Extension Type: Choice of: code, DataRequirement)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) popBasis-1: If DataRequirement.type is present, it may only contain the elements 'profile' and 'codeFilter'. (`value.exists() and value.is(DataRequirement) implies ( value.as(DataRequirement).type.exists() and value.as(DataRequirement).limit.empty() and value.as(DataRequirement).sort.empty() and value.as(DataRequirement).dateFilter.empty() and value.as(DataRequirement).subject.empty() and value.as(DataRequirement).mustSupport.empty())`)
18. Measure.extension:scoringUnit
Slice Name | scoringUnit
Definition | Defines the expected units of measure for the measure score.
Short | What units?
Control | 0..1 This element is affected by the following invariants: ele-1, comp-3
Type | Extension(CQM Scoring Unit) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
20. Measure.extension:effectiveDataRequirements
Slice Name | effectiveDataRequirements
Definition | A module definition library that contains the effective data requirements for the artifact (i.e. the calculated data requirements for the expressions referenced by the artifact structure).
Short | Effective required data for evaluation
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CRMI Effective Data Requirements) (Extension Type: canonical(CRMI Module Definition Library))
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
22. Measure.extension:scoringPrecision
Slice Name | scoringPrecision
Definition | Defines the precision of the measure score when it is a decimal value.
Short | Number of decimal places
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Scoring Precision) (Extension Type: positiveInt)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
24. Measure.extension:reportingTiming
Slice Name | reportingTiming
Definition | Specifies when the measure should be reported as a Timing data type
Short | When and how often the measure should be reported
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Reporting Timing) (Extension Type: Timing(CQM DataType Timing))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
26. Measure.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
28. Measure.url
Definition | An absolute URI that is used to identify this measure when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this measure is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the measure is stored on different servers.
Short | Canonical identifier for this measure, represented as a URI (globally unique)
Comments | Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version. The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions. In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the measure to be referenced by a single globally unique identifier.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
30. Measure.identifier
Definition | A formal identifier that is used to identify this measure when it is represented in other formats, or referenced in a specification, model, design or an instance.
Short | Additional identifier for the measure
Comments | Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this measure outside of FHIR, where it is not possible to use the logical URI.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Summary | true
Requirements | Allows externally provided and/or usable business identifiers to be easily associated with the module.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
32. Measure.version
Definition | The identifier that is used to identify this version of the measure when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the measure author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifacts.
Short | Business version of the measure
Comments | There may be different measure instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the measure with the format [url]|[version].
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
34. Measure.name
Definition | A natural language name identifying the measure. This name should be usable as an identifier for the module by machine processing applications such as code generation.
Short | Name for this measure (computer friendly)
Comments | The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.
Control | 0..1 This element is affected by the following invariants: inv-0
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Support human navigation and code generation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. Measure.title
Definition | A short, descriptive, user-friendly title for the measure.
Short | Name for this measure (human friendly)
Comments | This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
38. Measure.subtitle
Definition | An explanatory or alternate title for the measure giving additional information about its content.
Short | Subordinate title of the measure
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. Measure.status
Definition | The status of this measure. Enables tracking the life-cycle of the content.
Short | draft | active | retired | unknown
Comments | Allows filtering of measures that are appropriate for use versus not.
Control | 1..1
Binding | The codes SHALL be taken from PublicationStatus (required to `http://hl7.org/fhir/ValueSet/publication-status|4.0.1` ) The lifecycle status of an artifact.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. Measure.experimental
Definition | A Boolean value to indicate that this measure is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.
Short | For testing purposes, not real usage
Comments | Allows filtering of measures that are appropriate for use versus not.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Enables experimental content to be developed following the same lifecycle that would be used for a production-level measure.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. Measure.subject[x]
Definition | The intended subjects for the measure. If this element is not provided, a Patient subject is assumed, but the subject of the measure can be anything.
Short | E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
Comments | The subject of the measure is critical in interpreting the criteria definitions, as the logic in the measures is evaluated with respect to a particular subject. This corresponds roughly to the notion of a Compartment in that it limits what content is available based on its relationship to the subject. In CQL, this corresponds to the context declaration.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from Subject Type Value Set (extensible to `http://hl7.org/fhir/uv/cqm/ValueSet/subject-type` )
Type | Choice of: CodeableConcept, Reference(Group)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Meaning if Missing | Patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. Measure.date
Definition | The date (and optionally time) when the measure was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the measure changes.
Short | Date last changed
Comments | Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the measure. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | Revision Date
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. Measure.publisher
Definition | The name of the organization or individual that published the measure.
Short | Name of the publisher (organization or individual)
Comments | Usually an organization but may be an individual. The publisher (or steward) of the measure is the organization or individual primarily responsible for the maintenance and upkeep of the measure. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the measure. This item SHOULD be populated unless the information is available from context.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Helps establish the "authority/credibility" of the measure. May also allow for contact.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. Measure.contact
Definition | Contact details to assist a user in finding and communicating with the publisher.
Short | Contact details for the publisher
Comments | May be a web site, an email address, a telephone number, etc.
Control | 0..*
Type | ContactDetail
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. Measure.description
Definition | A free text natural language description of the measure from a consumer's perspective.
Short | Natural language description of the measure
Comments | This description can be used to capture details such as why the measure was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the measure as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the measure is presumed to be the predominant language in the place the measure was created).
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. Measure.useContext
Definition | The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate measure instances.
Short | The context that the content is intended to support
Comments | When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.
Control | 0..*
Type | UsageContext
Is Modifier | false
Summary | true
Requirements | Assist in searching for appropriate content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. Measure.jurisdiction
Definition | A legal or geographic region in which the measure is intended to be used.
Short | Intended jurisdiction for measure (if applicable)
Comments | It may be possible for the measure to be used in jurisdictions other than those for which it was originally designed or intended.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from Jurisdiction ValueSet (extensible to `http://hl7.org/fhir/ValueSet/jurisdiction|4.0.1` ) Countries and regions within which this artifact is targeted for use.
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. Measure.purpose
Definition | Explanation of why this measure is needed and why it has been designed as it has.
Short | Why this measure is defined
Comments | This element does not describe the usage of the measure. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this measure.
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. Measure.usage
Definition | A detailed description, from a clinical perspective, of how the measure is used.
Short | Describes the clinical usage of the measure
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. Measure.copyright
Definition | A copyright statement relating to the measure and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the measure.
Short | Use and/or publishing restrictions
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Consumers must be able to determine any legal restrictions on the use of the measure and/or its content.
Alternate Names | License, Restrictions
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
64. Measure.approvalDate
Definition | The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.
Short | When the measure was approved by publisher
Comments | The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.
Control | 0..1
Type | date
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. Measure.lastReviewDate
Definition | The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.
Short | When the measure was last reviewed
Comments | If specified, this date follows the original approval date.
Control | 0..1
Type | date
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. Measure.effectivePeriod
Definition | The period during which the measure content was or is planned to be in active use.
Short | When the measure is expected to be used
Comments | The effective period for a measure determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Requirements | Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the measure are or are expected to be used instead.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. Measure.topic
Definition | Descriptive topics related to the content of the measure. Topics provide a high-level categorization grouping types of measures that can be useful for filtering and searching.
Short | The category of the measure, such as Education, Treatment, Assessment, etc.
Control | 0..*
Binding | For example codes, see DefinitionTopic (example to `http://hl7.org/fhir/ValueSet/definition-topic|4.0.1` ) High-level categorization of the definition, used for searching, sorting, and filtering.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Repositories must be able to determine how to categorize the measure so that it can be found by topical searches.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. Measure.author
Definition | An individiual or organization primarily involved in the creation and maintenance of the content.
Short | Who authored the content
Control | 0..*
Type | ContactDetail
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. Measure.editor
Definition | An individual or organization primarily responsible for internal coherence of the content.
Short | Who edited the content
Control | 0..*
Type | ContactDetail
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. Measure.reviewer
Definition | An individual or organization primarily responsible for review of some aspect of the content.
Short | Who reviewed the content
Control | 0..*
Type | ContactDetail
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. Measure.endorser
Definition | An individual or organization responsible for officially endorsing the content for use in some setting.
Short | Who endorsed the content
Control | 0..*
Type | ContactDetail
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. Measure.relatedArtifact
Definition | Related artifacts such as additional documentation, justification, or bibliographic references.
Short | Additional documentation, citations, etc.
Comments | Each related artifact is either an attachment, or a reference to another resource, but not both.
Control | 0..*
Type | RelatedArtifact
Is Modifier | false
Summary | false
Requirements | Measures must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. Measure.library
Definition | A reference to a Library resource containing the formal logic used by the measure.
Short | Logic used by the measure
Control | 0..1
Type | canonical(CRMI Computable Library)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. Measure.disclaimer
Definition | Notices and disclaimers regarding the use of the measure or related to intellectual property (such as code systems) referenced by the measure.
Short | Disclaimer for use of the measure or its referenced content
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Some organizations require that notices and disclosures be included when publishing measures that reference their intellecutal property.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. Measure.scoring
Definition | Indicates how the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort. The value set is extensible, allowing additional measure scoring types to be represented.
Short | ratio
Control | 0..1 This element is affected by the following invariants: comp-2, comp-3, comp-4
Binding | Unless not suitable, these codes SHALL be taken from Measure Scoring (extensible to `http://terminology.hl7.org/ValueSet/measure-scoring` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring", "code" : "ratio" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
88. Measure.compositeScoring
Definition | If this is a composite measure, the scoring method used to combine the component measures to determine the composite score.
Short | opportunity | all-or-nothing | linear | weighted
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from CompositeMeasureScoring (extensible to `http://hl7.org/fhir/ValueSet/composite-measure-scoring|4.0.1` ) The composite scoring method of the measure.
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
90. Measure.type
Definition | Indicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilization.
Short | Indicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilization.
Control | 0..* This element is affected by the following invariants: comp-5
Binding | Unless not suitable, these codes SHALL be taken from ObservationMeasureType (extensible to `http://terminology.hl7.org/ValueSet/v3-ObservationMeasureType` ) Indicates the type of quality measure based on the observation value.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
92. Measure.riskAdjustment
Definition | A description of the risk adjustment factors that may impact the resulting score for the measure and how they may be accounted for when computing and reporting measure results.
Short | How risk adjustment is applied for this measure
Comments | Describes the method of adjusting for clinical severity and conditions present at the start of care that can influence patient outcomes for making valid comparisons of outcome measures across providers. Indicates whether a measure is subject to the statistical process for reducing, removing, or clarifying the influences of confounding factors to allow for more useful comparisons.
Control | 0..1 This element is affected by the following invariants: comp-6
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
94. Measure.rateAggregation
Definition | Describes how to combine the information calculated, based on logic in each of several populations, into one summarized result.
Short | How is rate aggregation performed for this measure
Comments | The measure rate for an organization or clinician is based upon the entities’ aggregate data and summarizes the performance of the entity over a given time period (e.g., monthly, quarterly, yearly). The aggregated data are derived from the results of a specific measure algorithm and, if appropriate, the application of specific risk adjustment models. Can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure (e.g., pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two). This could be applied to aggregated cohort measure definitions (e.g., CDC's aggregate reporting for TB at the state level).
Control | 0..1 This element is affected by the following invariants: comp-7
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
96. Measure.rationale
Definition | Provides a succinct statement of the need for the measure. Usually includes statements pertaining to importance criterion: impact, gap in care, and evidence.
Short | Detailed description of why the measure exists
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Measure developers need to be able to provide a detailed description of the purpose of the measure. This element provides detailed rationale, where the purpose element provides a summary of the rationale.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
98. Measure.clinicalRecommendationStatement
Definition | Provides a summary of relevant clinical guidelines or other clinical recommendations supporting the measure.
Short | Summary of clinical guidelines
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. Measure.improvementNotation
Definition | Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range).
Short | increase | decrease
Control | 0..1 This element is affected by the following invariants: comp-4
Binding | The codes SHALL be taken from MeasureImprovementNotation (required to `http://terminology.hl7.org/ValueSet/measure-improvement-notation` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Measure consumers and implementers must be able to determine how to interpret a measure score.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
102. Measure.definition
Definition | Provides a description of an individual term used within the measure.
Short | Defined terms used in the measure documentation
Control | 0..*
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Measure developers must be able to provide precise definitions of terms used within measure descriptions and guidance to help communicate the intent of the measure.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
104. Measure.guidance
Definition | Additional guidance for the measure including how it can be used in a clinical context, and the intent of the measure.
Short | Additional guidance for implementers
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Measure developers must be able to provide additional guidance for implementers to understand the intent with greater specificity than that provided in the population criteria of the measure. This element provides detailed guidance, where the usage element provides a summary of the guidance.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
106. Measure.group
Definition | A group of population criteria for the measure.
Short | Population criteria group
Control | 1..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) comp-8: Scoring unit may only be specified at the root if the scoring is also specified at the root (`extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()`) comp-9: If scoring is specified on the group and the scoring type is 'proportion', 'ratio', or 'continuous-variable' then the improvementNotation element is required. (`extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable') implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation').exists()`) cmp-13: Ratio measures may not have other than initial population, denominator, numerator, denominator-exclusion, numerator-exclusion, and measure-observation criteria (`extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'ratio' implies population.select(code.coding.where(system = 'http://terminology.hl7.org/CodeSystem/measure-population').code in ('initial-population' | 'numerator' | 'denominator' | 'denominator-exclusion' | 'measure-observation' | 'numerator-exclusion')).allTrue()`)
108. Measure.group.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
110. Measure.group.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.group.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
112. Measure.group.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the group
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
114. Measure.group.extension:populationBasis
Slice Name | populationBasis
Definition | The population basis specifies the type of elements in the population. For a subject-based measure, this is boolean (because the subject and the population basis are the same, and the population criteria define yes/no values for each individual in the population). For measures that have a population basis that is different than the subject, this element specifies the type of the population basis. For example, an encounter-based measure has a subject of Patient and a population basis of Encounter, and the population criteria all return lists of Encounters.
Short | What type of population
Comments | In Health Quality Measure Format, this was referred to as the Item Count metadata attribute. If the populationBasis is specified as a data requirement, the type SHALL be present, profile and codeFilter MAY be present, and no other elements are allowed. This usage allows population basis to be stated with more specificity, e.g. CT Scans, rather than just DiagnosticReport.
Control | 0..1 This element is affected by the following invariants: ele-1, comp-1
Type | Extension(CQM Population Basis) (Extension Type: Choice of: code, DataRequirement)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) popBasis-1: If DataRequirement.type is present, it may only contain the elements 'profile' and 'codeFilter'. (`value.exists() and value.is(DataRequirement) implies ( value.as(DataRequirement).type.exists() and value.as(DataRequirement).limit.empty() and value.as(DataRequirement).sort.empty() and value.as(DataRequirement).dateFilter.empty() and value.as(DataRequirement).subject.empty() and value.as(DataRequirement).mustSupport.empty())`)
116. Measure.group.extension:scoring
Slice Name | scoring
Definition | Indicates how the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort. The value set is extensible, allowing additional measure scoring types to be represented. When present on a group, specifies the scoring to be used for this group, overriding the scoring specified for the overall measure.
Short | proportion | ratio | continuous-variable | cohort
Control | 0..1 This element is affected by the following invariants: ele-1, comp-2, comp-8, comp-9, cmp-13
Type | Extension(CQM Scoring) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
118. Measure.group.extension:scoringUnit
Slice Name | scoringUnit
Definition | Defines the expected units of measure for the measure score.
Short | What units?
Control | 0..1 This element is affected by the following invariants: ele-1, comp-8
Type | Extension(CQM Scoring Unit) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
120. Measure.group.extension:scoringPrecision
Slice Name | scoringPrecision
Definition | Defines the precision of the measure score when it is a decimal value.
Short | Number of decimal places
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Scoring Precision) (Extension Type: positiveInt)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
122. Measure.group.extension:compositeScoring
Slice Name | compositeScoring
Definition | Indicates how the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort. The value set is extensible, allowing additional measure scoring types to be represented. When present on a group, specifies the scoring to be used for this group, overriding the scoring specified for the overall measure.
Short | proportion | ratio | continuous-variable | cohort
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Composite Scoring) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
124. Measure.group.extension:component
Slice Name | component
Definition | Specifies an artifact this is a component of a composite artifact.
Short | What artifact
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(CQM Component) (Extension Type: RelatedArtifact)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
126. Measure.group.extension:type
Slice Name | type
Definition | Indicates the type of quality measure based on the observation value.
Short | Extension
Control | 0..* This element is affected by the following invariants: ele-1, comp-5
Type | Extension(CQM Type) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
128. Measure.group.extension:riskAdjustment
Slice Name | riskAdjustment
Definition | A description of the risk adjustment factors that may impact the resulting score for the measure and how they may be accounted for when computing and reporting measure results.
Short | How risk adjustment is applied for this measure
Comments | Describes the method of adjusting for clinical severity and conditions present at the start of care that can influence patient outcomes for making valid comparisons of outcome measures across providers. Indicates whether a measure is subject to the statistical process for reducing, removing, or clarifying the influences of confounding factors to allow for more useful comparisons.
Control | 0..1 This element is affected by the following invariants: ele-1, comp-6
Type | Extension(CQM Risk Adjustment) (Extension Type: string)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
130. Measure.group.extension:rateAggregation
Slice Name | rateAggregation
Definition | Describes how to combine the information calculated, based on logic in each of several populations, into one summarized result.
Short | How is rate aggregation performed for this measure
Comments | The measure rate for an organization or clinician is based upon the entities’ aggregate data and summarizes the performance of the entity over a given time period (e.g., monthly, quarterly, yearly). The aggregated data are derived from the results of a specific measure algorithm and, if appropriate, the application of specific risk adjustment models. Can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure (e.g., pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two). This could be applied to aggregated cohort measure definitions (e.g., CDC's aggregate reporting for TB at the state level).
Control | 0..1 This element is affected by the following invariants: ele-1, comp-7
Type | Extension(CQM Rate Aggregation) (Extension Type: string)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
132. Measure.group.extension:improvementNotation
Slice Name | improvementNotation
Definition | Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range).
Short | increase | decrease
Control | 0..1 This element is affected by the following invariants: ele-1, comp-9
Type | Extension(CQM Improvement Notation) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
134. Measure.group.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
136. Measure.group.code
Definition | Indicates a meaning for the group. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing groups to be correlated across measures.
Short | Meaning of the group
Control | 0..1
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
138. Measure.group.description
Definition | The human readable description of this population group.
Short | Summary description
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
140. Measure.group.population
Definition | A population criteria for the measure.
Short | Population criteria
Control | 4..8 This element is affected by the following invariants: cmp-13
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Measure.group.population`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ code
142. Measure.group.population.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
144. Measure.group.population.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.group.population.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
146. Measure.group.population.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the population
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.population.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
148. Measure.group.population.extension:supportingEvidenceDefinition
Slice Name | supportingEvidenceDefinition
Definition | An Extension
Short | Extension
Control | 0..1
Type | Extension(`http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition`)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
150. Measure.group.population.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
152. Measure.group.population.code
Definition | The type of population criteria.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType (extensible to `http://hl7.org/fhir/ValueSet/measure-population|4.0.1` ) The type of population.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
154. Measure.group.population.description
Definition | The human readable description of this population criteria.
Short | The human readable description of this population criteria
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
156. Measure.group.population.criteria
Definition | An expression that specifies the criteria for the population, typically the name of an expression in a library.
Short | The criteria that defines this population
Comments | In the case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
158. Measure.group.population:initialPopulation
Slice Name | initialPopulation
Definition | A population criteria for the measure.
Short | Initial Population
Control | 1..2
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
160. Measure.group.population:initialPopulation.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
162. Measure.group.population:initialPopulation.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.group.population.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
164. Measure.group.population:initialPopulation.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the population
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.population.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
166. Measure.group.population:initialPopulation.extension:supportingEvidenceDefinition
Slice Name | supportingEvidenceDefinition
Definition | An Extension
Short | Extension
Control | 0..1
Type | Extension(`http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition`)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
168. Measure.group.population:initialPopulation.extension:populationBasis
Slice Name | populationBasis
Definition | The population basis specifies the type of elements in the population. For a subject-based measure, this is boolean (because the subject and the population basis are the same, and the population criteria define yes/no values for each individual in the population). For measures that have a population basis that is different than the subject, this element specifies the type of the population basis. For example, an encounter-based measure has a subject of Patient and a population basis of Encounter, and the population criteria all return lists of Encounters.
Short | Allows the populationBasis for that population to be overridden. If not present, the populationBasis of the measure (or group) is used. If present, it specifies the population basis for all the expressions that use it as the initial population in the ratio measure.
Comments | In Health Quality Measure Format, this was referred to as the Item Count metadata attribute. If the populationBasis is specified as a data requirement, the type SHALL be present, profile and codeFilter MAY be present, and no other elements are allowed. This usage allows population basis to be stated with more specificity, e.g. CT Scans, rather than just DiagnosticReport.
Control | 0..*
Type | Extension(CQM Population Basis) (Extension Type: Choice of: code, DataRequirement)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
170. Measure.group.population:initialPopulation.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
172. Measure.group.population:initialPopulation.code
Definition | The type of population criteria.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType (extensible to `http://hl7.org/fhir/ValueSet/measure-population|4.0.1` ) The type of population.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "initial-population" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
174. Measure.group.population:initialPopulation.description
Definition | The human readable description of this population criteria.
Short | The human readable description of this population criteria
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
176. Measure.group.population:initialPopulation.criteria
Definition | An expression that specifies the criteria for the population, typically the name of an expression in a library.
Short | The criteria that defines this population
Comments | In the case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
178. Measure.group.population:denominator
Slice Name | denominator
Definition | A population criteria for the measure.
Short | Denominator
Control | 1..1
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
180. Measure.group.population:denominator.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
182. Measure.group.population:denominator.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.group.population.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
184. Measure.group.population:denominator.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the population
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.population.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
186. Measure.group.population:denominator.extension:supportingEvidenceDefinition
Slice Name | supportingEvidenceDefinition
Definition | An Extension
Short | Extension
Control | 0..1
Type | Extension(`http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition`)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
188. Measure.group.population:denominator.extension:criteriaReference
Slice Name | criteriaReference
Definition | Reference a criteria by specifying that criteria's unique id
Short | Criteria reference
Comments | When used in a MeasureReport, this is a reference to the id of a criteria within the Measure referenced by the MeasureReport.
Control | 0..1
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
190. Measure.group.population:denominator.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
192. Measure.group.population:denominator.code
Definition | The type of population criteria.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType (extensible to `http://hl7.org/fhir/ValueSet/measure-population|4.0.1` ) The type of population.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "denominator" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
194. Measure.group.population:denominator.description
Definition | The human readable description of this population criteria.
Short | The human readable description of this population criteria
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
196. Measure.group.population:denominator.criteria
Definition | An expression that specifies the criteria for the population, typically the name of an expression in a library.
Short | The criteria that defines this population
Comments | In the case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
198. Measure.group.population:denominatorExclusion
Slice Name | denominatorExclusion
Definition | A population criteria for the measure.
Short | Denominator Exclusion
Control | 0..1
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
200. Measure.group.population:denominatorExclusion.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
202. Measure.group.population:denominatorExclusion.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.group.population.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
204. Measure.group.population:denominatorExclusion.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the population
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.population.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
206. Measure.group.population:denominatorExclusion.extension:supportingEvidenceDefinition
Slice Name | supportingEvidenceDefinition
Definition | An Extension
Short | Extension
Control | 0..1
Type | Extension(`http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition`)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
208. Measure.group.population:denominatorExclusion.extension:criteriaReference
Slice Name | criteriaReference
Definition | Reference a criteria by specifying that criteria's unique id
Short | Criteria reference
Comments | When used in a MeasureReport, this is a reference to the id of a criteria within the Measure referenced by the MeasureReport.
Control | 0..1
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
210. Measure.group.population:denominatorExclusion.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
212. Measure.group.population:denominatorExclusion.code
Definition | The type of population criteria.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType (extensible to `http://hl7.org/fhir/ValueSet/measure-population|4.0.1` ) The type of population.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "denominator-exclusion" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
214. Measure.group.population:denominatorExclusion.description
Definition | The human readable description of this population criteria.
Short | The human readable description of this population criteria
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
216. Measure.group.population:denominatorExclusion.criteria
Definition | An expression that specifies the criteria for the population, typically the name of an expression in a library.
Short | The criteria that defines this population
Comments | In the case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
218. Measure.group.population:numerator
Slice Name | numerator
Definition | A population criteria for the measure.
Short | Numerator
Control | 1..1
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
220. Measure.group.population:numerator.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
222. Measure.group.population:numerator.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.group.population.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
224. Measure.group.population:numerator.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the population
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.population.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
226. Measure.group.population:numerator.extension:supportingEvidenceDefinition
Slice Name | supportingEvidenceDefinition
Definition | An Extension
Short | Extension
Control | 0..1
Type | Extension(`http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition`)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
228. Measure.group.population:numerator.extension:criteriaReference
Slice Name | criteriaReference
Definition | Reference a criteria by specifying that criteria's unique id
Short | Criteria reference
Comments | When used in a MeasureReport, this is a reference to the id of a criteria within the Measure referenced by the MeasureReport.
Control | 0..1
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
230. Measure.group.population:numerator.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
232. Measure.group.population:numerator.code
Definition | The type of population criteria.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType (extensible to `http://hl7.org/fhir/ValueSet/measure-population|4.0.1` ) The type of population.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "numerator" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
234. Measure.group.population:numerator.description
Definition | The human readable description of this population criteria.
Short | The human readable description of this population criteria
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
236. Measure.group.population:numerator.criteria
Definition | An expression that specifies the criteria for the population, typically the name of an expression in a library.
Short | The criteria that defines this population
Comments | In the case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
238. Measure.group.population:numeratorExclusion
Slice Name | numeratorExclusion
Definition | A population criteria for the measure.
Short | Numerator Exclusion
Control | 0..1
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
240. Measure.group.population:numeratorExclusion.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
242. Measure.group.population:numeratorExclusion.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.group.population.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
244. Measure.group.population:numeratorExclusion.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the population
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.population.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
246. Measure.group.population:numeratorExclusion.extension:supportingEvidenceDefinition
Slice Name | supportingEvidenceDefinition
Definition | An Extension
Short | Extension
Control | 0..1
Type | Extension(`http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition`)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
248. Measure.group.population:numeratorExclusion.extension:criteriaReference
Slice Name | criteriaReference
Definition | Reference a criteria by specifying that criteria's unique id
Short | Criteria reference
Comments | When used in a MeasureReport, this is a reference to the id of a criteria within the Measure referenced by the MeasureReport.
Control | 0..1
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
250. Measure.group.population:numeratorExclusion.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
252. Measure.group.population:numeratorExclusion.code
Definition | The type of population criteria.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType (extensible to `http://hl7.org/fhir/ValueSet/measure-population|4.0.1` ) The type of population.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "numerator-exclusion" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
254. Measure.group.population:numeratorExclusion.description
Definition | The human readable description of this population criteria.
Short | The human readable description of this population criteria
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
256. Measure.group.population:numeratorExclusion.criteria
Definition | An expression that specifies the criteria for the population, typically the name of an expression in a library.
Short | The criteria that defines this population
Comments | In the case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
258. Measure.group.population:measureObservation
Slice Name | measureObservation
Definition | A population criteria for the measure.
Short | Measure Observation
Control | 0..2
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
260. Measure.group.population:measureObservation.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
262. Measure.group.population:measureObservation.extension
Definition | An Extension
Short | Extension
Control | 2..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.group.population.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
264. Measure.group.population:measureObservation.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the population
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.population.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
266. Measure.group.population:measureObservation.extension:supportingEvidenceDefinition
Slice Name | supportingEvidenceDefinition
Definition | An Extension
Short | Extension
Control | 0..1
Type | Extension(`http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition`)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
268. Measure.group.population:measureObservation.extension:criteriaReference
Slice Name | criteriaReference
Definition | Reference a criteria by specifying that criteria's unique id
Short | Criteria reference
Comments | When used in a MeasureReport, this is a reference to the id of a criteria within the Measure referenced by the MeasureReport.
Control | 0..1
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
270. Measure.group.population:measureObservation.extension:aggregateMethod
Slice Name | aggregateMethod
Definition | Specifies which method to be used to aggregate the measure observation values.
Short | Aggregate with
Control | 1..1
Type | Extension(CQM Aggregate Method) (Extension Type: code)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
272. Measure.group.population:measureObservation.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
274. Measure.group.population:measureObservation.code
Definition | The type of population criteria.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType (extensible to `http://hl7.org/fhir/ValueSet/measure-population|4.0.1` ) The type of population.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "measure-observation" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
276. Measure.group.population:measureObservation.description
Definition | The human readable description of this population criteria.
Short | The human readable description of this population criteria
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
278. Measure.group.population:measureObservation.criteria
Definition | An expression that specifies the criteria for the population, typically the name of an expression in a library.
Short | The criteria that defines this population
Comments | In the case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
280. Measure.group.stratifier
Definition | The stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library or a valid FHIR Resource Path.
Short | Stratifier criteria for the measure
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
282. Measure.group.stratifier.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
284. Measure.group.stratifier.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.group.stratifier.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
286. Measure.group.stratifier.extension:appliesTo
Slice Name | appliesTo
Definition | Indicates the population that this stratifier should apply to. If no appliesTo extension is present, the stratifier is calculated based on the result of the population calculation (e.g. the calculated numerator for a proportion scoring).
Short | Which population does this stratifier apply to?
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(CQM Applies To) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
288. Measure.group.stratifier.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the stratifier
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.stratifier.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
290. Measure.group.stratifier.extension:valueSet
Slice Name | valueSet
Definition | A value set defining the set of possible values for stratum in this stratifier. If criteria and valueSet are both present, they SHALL be consistent (i.e. criteria expressions SHALL produce stratum values that are codes in the value set referenced by this element). Note that this MAY be strictly at the code level (e.g. an Age Range code that is just the string value 01Y--05Y with the system ignored).
Short | What stratum values?
Comments | This element may be used to define a stratifier rather than requiring the stratifier be defined with logic. For example, a measure may reference a value set defining possible age ranges, rather than (and potentially in addition to) embedding the calculation of the age ranges into measure logic. See the MeasureStratifierAgeRangeExample value set for an example. If present, the value set SHALL be consistent with the criteria (i.e., the criteria, when evaluated, will result in values from the value set).
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Value Set) (Extension Type: canonical)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
292. Measure.group.stratifier.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
294. Measure.group.stratifier.code
Definition | Indicates a meaning for the stratifier. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing stratifiers to be correlated across measures.
Short | Meaning of the stratifier
Control | 0..1
Binding | The codes SHOULD be taken from Measure Stratifier Type (preferred to `http://terminology.hl7.org/ValueSet/measure-stratifier-type` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
296. Measure.group.stratifier.description
Definition | The human readable description of this stratifier criteria.
Short | The human readable description of this stratifier
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
298. Measure.group.stratifier.criteria
Definition | An expression that specifies the criteria for the stratifier. This is typically the name of an expression defined within a referenced library, but it may also be a path to a stratifier element.
Short | How the measure should be stratified
Control | 0..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
300. Measure.group.stratifier.component
Definition | A component of the stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library or a valid FHIR Resource Path.
Short | Stratifier criteria component for the measure
Comments | Stratifiers are defined either as a single criteria, or as a set of component criteria.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
302. Measure.group.stratifier.component.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
304. Measure.group.stratifier.component.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.group.stratifier.component.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
306. Measure.group.stratifier.component.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the stratifier component
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.group.stratifier.component.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
308. Measure.group.stratifier.component.extension:valueSet
Slice Name | valueSet
Definition | A value set defining the set of possible values for stratum in this stratifier. If criteria and valueSet are both present, they SHALL be consistent (i.e. criteria expressions SHALL produce stratum values that are codes in the value set referenced by this element). Note that this MAY be strictly at the code level (e.g. an Age Range code that is just the string value 01Y--05Y with the system ignored).
Short | What stratum values?
Comments | This element may be used to define a stratifier rather than requiring the stratifier be defined with logic. For example, a measure may reference a value set defining possible age ranges, rather than (and potentially in addition to) embedding the calculation of the age ranges into measure logic. See the MeasureStratifierAgeRangeExample value set for an example. If present, the value set SHALL be consistent with the criteria (i.e., the criteria, when evaluated, will result in values from the value set).
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Value Set) (Extension Type: canonical)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
310. Measure.group.stratifier.component.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
312. Measure.group.stratifier.component.code
Definition | Indicates a meaning for the stratifier component. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing stratifiers to be correlated across measures.
Short | Meaning of the stratifier component
Control | 0..1
Binding | The codes SHOULD be taken from Measure Stratifier Type (preferred to `http://terminology.hl7.org/ValueSet/measure-stratifier-type` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
314. Measure.group.stratifier.component.description
Definition | The human readable description of this stratifier criteria component.
Short | The human readable description of this stratifier component
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
316. Measure.group.stratifier.component.criteria
Definition | An expression that specifies the criteria for this component of the stratifier. This is typically the name of an expression defined within a referenced library, but it may also be a path to a stratifier element.
Short | Component of how the measure should be stratified
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
318. Measure.supplementalData
Definition | The supplemental data criteria for the measure report, specified as either the name of a valid CQL expression within a referenced library, or a valid FHIR Resource Path.
Short | What other data should be reported with the measure
Comments | Note that supplemental data are reported as observations for each patient and included in the evaluatedResources bundle. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
320. Measure.supplementalData.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
322. Measure.supplementalData.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.supplementalData.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
324. Measure.supplementalData.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the supplemental data
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Measure.supplementalData.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
326. Measure.supplementalData.extension:valueSet
Slice Name | valueSet
Definition | A value set defining the set of possible values for stratum in this stratifier. If criteria and valueSet are both present, they SHALL be consistent (i.e. criteria expressions SHALL produce stratum values that are codes in the value set referenced by this element). Note that this MAY be strictly at the code level (e.g. an Age Range code that is just the string value 01Y--05Y with the system ignored).
Short | What stratum values?
Comments | This element may be used to define a stratifier rather than requiring the stratifier be defined with logic. For example, a measure may reference a value set defining possible age ranges, rather than (and potentially in addition to) embedding the calculation of the age ranges into measure logic. See the MeasureStratifierAgeRangeExample value set for an example. If present, the value set SHALL be consistent with the criteria (i.e., the criteria, when evaluated, will result in values from the value set).
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Value Set) (Extension Type: canonical)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
328. Measure.supplementalData.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
330. Measure.supplementalData.code
Definition | Indicates a meaning for the supplemental data. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing supplemental data to be correlated across measures.
Short | Meaning of the supplemental data
Control | 0..1
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
332. Measure.supplementalData.usage
Definition | An indicator of the intended usage for the supplemental data element. Supplemental data indicates the data is additional information requested to augment the measure information. Risk adjustment factor indicates the data is additional information used to calculate risk adjustment factors when applying a risk model to the measure calculation.
Short | supplemental-data | risk-adjustment-factor
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from MeasureDataUsage (extensible to `http://hl7.org/fhir/ValueSet/measure-data-usage|4.0.1` ) The intended usage for supplemental data elements in the measure.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
334. Measure.supplementalData.description
Definition | The human readable description of this supplemental data.
Short | The human readable description of this supplemental data
Comments | Although this element is string-valued, it will be markdown valued in future versions so systems should be able to render markdown content when it appears in this element
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
336. Measure.supplementalData.criteria
Definition | The criteria for the supplemental data. This is typically the name of a valid expression defined within a referenced library, but it may also be a path to a specific data element. The criteria defines the data to be returned for this element.
Short | Expression describing additional data to be reported
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)