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

## Resource Profile: CQM Computable Measure

Official URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure | Version: 1.0.0 | Highlight text changes?
Standards status: Trial-use Active as of 2026-04-07 | Maturity Level: 4 | Computable Name: CQMComputableMeasure
Other Identifiers: OID:2.16.840.1.113883.4.642.40.61.42.8

The CQM Computable Measure Profile describes minimum expectations for a computable electronic Quality Measure (QM), including the use of a computable library. For more information on the usage of this profile, refer to the Profiles and Packaging pages in this implementation guide. Implementations SHOULD support using the `id` elements of group, population, stratifier, and supplementalData as a backwards-compatible mechanism for linking between Measure and MeasureReport

Usages:

- Derived from this Profile: CQM Cohort Measure, CQM Composite Measure, CQM Continuous Variable Measure, CQM Proportion Measure and CQM Ratio Measure
- Examples for this Profile: BCSComponent, BedCapacityMeasureDaily, BedCapacityMeasureMonthly, CCSComponent... Show 15 more, EXM108, EXM124, EXM125, EXM130, EXM146, EXM55, MeasureEXM, EXMRatioMeasure, HBPComponent, MultiRateExample, PVSComponent, TSCComponent, Terminology_FHIR, MeasureAgeStratifiedExample and PublishableMeasureEXM
- CapabilityStatements using this Profile: CQF Measures Shareable Measure Repository Capability Statement

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Measure | S C | 0..* | Measure | A quality measure definition Constraints: mea-0, mea-1, comp-1, comp-2, comp-3, comp-4, comp-5, comp-6, comp-7
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:populationBasis | S C | 0..* | code, DataRequirement | What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population Constraints: popBasis-1
extension:scoringUnit | S C | 0..1 | CodeableConcept | What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:effectiveDataRequirements | S | 0..1 | canonical(CRMI Module Definition Library) | Effective required data for evaluation URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
extension:scoringPrecision |  | 0..1 | positiveInt | Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
extension:reportingTiming |  | 0..1 | CQMDataTypeTiming | When and how often the measure should be reported URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-reportingTiming
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
subject[x] | S | 0..1 |  | E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: Subject Type Value Set (extensible)
subjectCodeableConcept |  |  | CodeableConcept |
subjectReference |  |  | Reference(Group) |
usage | S | 0..1 | string | Describes the clinical usage of the measure
library | S | 0..1 | canonical(CRMI Computable Library) | Logic used by the measure
scoring | S Σ C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort Binding: Measure Scoring (extensible)
type | S Σ C | 0..* | CodeableConcept | 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. Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
riskAdjustment | Σ C | 0..1 | string | How risk adjustment is applied for this measure
rateAggregation | Σ C | 0..1 | string | How is rate aggregation performed for this measure
improvementNotation | S Σ C | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required)
group | S C | 0..* | BackboneElement | Population criteria group Constraints: comp-8, comp-9
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the group URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId
extension:populationBasis | S C | 0..1 | code, DataRequirement | What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population Constraints: popBasis-1
extension:scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring Binding: Measure Scoring (extensible): How the measure calculation is performed
extension:scoringUnit | S C | 0..1 | CodeableConcept | What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:scoringPrecision |  | 0..1 | positiveInt | Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
extension:compositeScoring | S | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
extension:component | S | 0..* | RelatedArtifact | What artifact URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
extension:type | C | 0..* | CodeableConcept | Extension URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
extension:riskAdjustment | C | 0..1 | string | How risk adjustment is applied for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
extension:rateAggregation | C | 0..1 | string | How is rate aggregation performed for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
extension:improvementNotation | S C | 0..1 | CodeableConcept | increase | decrease URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | Meaning of the group
description | S | 0..1 | string | Summary description
population | S | 0..* | BackboneElement | Population criteria
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the population URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
extension:supportingEvidenceDefinition | S | 0..1 | ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition]] | Extension URL: http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population.
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
stratifier | S | 0..* | BackboneElement | Stratifier criteria for the measure
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:appliesTo |  | 0..* | CodeableConcept | Which population does this stratifier apply to? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo Binding: MeasurePopulationType (extensible): Indicates the population
extension:linkId | S | 1..1 | string | Unique id of the stratifier URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId
extension:valueSet |  | 0..1 | canonical(ValueSet) | What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | Meaning of the stratifier Binding: Measure Stratifier Type (preferred)
description | S | 0..1 | string | The human readable description of this stratifier
component | S | 0..* | BackboneElement | Stratifier criteria component for the measure
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the stratifier component URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.component.linkId
extension:valueSet |  | 0..1 | canonical(ValueSet) | What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | Meaning of the stratifier component Binding: Measure Stratifier Type (preferred)
description | S | 0..1 | string | The human readable description of this stratifier component
criteria |  | 1..1 | Expression | Component of how the measure should be stratified
supplementalData | S | 0..* | BackboneElement | What other data should be reported with the measure
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the supplemental data URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
extension:valueSet |  | 0..1 | canonical(ValueSet) | What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | Meaning of the supplemental data
usage | S | 0..* | CodeableConcept | supplemental-data | risk-adjustment-factor Binding: MeasureDataUsage (extensible): The intended usage for supplemental data elements in the measure.
description | S | 0..1 | string | The human readable description of this supplemental data
criteria |  | 1..1 | Expression | Expression describing additional data to be reported
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Measure.status | Base | required | PublicationStatus | 📍4.0.1 | FHIR Std.
Measure.subject[x] | Base | extensible | Subject Type Value Set | 📦4.0.0 | This IG
Measure.scoring | Base | extensible | Measure Scoring | 📦2.0.0 | THO v7.1
Measure.type | Base | extensible | ObservationMeasureType | 📦3.0.0 | THO v7.1
Measure.improvementNotation | Base | required | MeasureImprovementNotation | 📦1.0.1 | THO v7.1
Measure.group.population.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.stratifier.​code | Base | preferred | Measure Stratifier Type | 📦1.0.0 | This IG
Measure.group.stratifier.​component.code | Base | preferred | Measure Stratifier Type | 📦1.0.0 | This IG
Measure.supplementalData.​usage | Base | extensible | MeasureDataUsage | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
comp-1 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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()`
comp-8 | error | Measure.group | 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 | error | Measure.group | 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()`
dom-2 | error | Measure | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Measure | 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 | error | Measure | 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 | error | Measure | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Measure | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mea-0 | warning | Measure | 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 | error | Measure | Stratifier SHALL be either a single criteria or a set of criteria components | `group.stratifier.all((code | description | criteria).exists() xor component.exists())`
popBasis-1 | error | Measure.extension:populationBasis, Measure.group.extension:populationBasis | 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())`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Measure | S C | 0..* | Measure | A quality measure definition Constraints: comp-1, comp-2, comp-3, comp-4, comp-5, comp-6, comp-7
Slices for extension |  |  |  | Content/Rules for all slices
extension:populationBasis | S C | 0..* | code, DataRequirement | What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
extension:scoringUnit | S C | 0..1 | CodeableConcept | What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:effectiveDataRequirements | S | 0..1 | canonical(CRMI Module Definition Library) | Effective required data for evaluation URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
extension:scoringPrecision |  | 0..1 | positiveInt | Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
extension:reportingTiming |  | 0..1 | CQMDataTypeTiming | When and how often the measure should be reported URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-reportingTiming
subject[x] | S | 0..1 | CodeableConcept, Reference(Group) | E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: Subject Type Value Set (extensible)
usage | S | 0..1 | string | Describes the clinical usage of the measure
library | S | 0..1 | canonical(CRMI Computable Library) | Logic used by the measure
scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort Binding: Measure Scoring (extensible)
type | S Σ C | 0..* | CodeableConcept | 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. Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
riskAdjustment | C | 0..1 | string | How risk adjustment is applied for this measure
rateAggregation | C | 0..1 | string | How is rate aggregation performed for this measure
improvementNotation | S C | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required)
group | S C | 0..* | BackboneElement | Population criteria group Constraints: comp-8, comp-9
Slices for extension |  |  |  | Content/Rules for all slices
extension:linkId | S | 1..1 | string | Unique id of the group URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId
extension:populationBasis | S C | 0..1 | code, DataRequirement | What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
extension:scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring Binding: Measure Scoring (extensible): How the measure calculation is performed
extension:scoringUnit | S C | 0..1 | CodeableConcept | What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:scoringPrecision |  | 0..1 | positiveInt | Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
extension:compositeScoring | S | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
extension:component | S | 0..* | RelatedArtifact | What artifact URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
extension:type | C | 0..* | CodeableConcept | Extension URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
extension:riskAdjustment | C | 0..1 | string | How risk adjustment is applied for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
extension:rateAggregation | C | 0..1 | string | How is rate aggregation performed for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
extension:improvementNotation | S C | 0..1 | CodeableConcept | increase | decrease URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure
code | S | 0..1 | CodeableConcept | Meaning of the group
description | S | 0..1 | string | Summary description
population | S | 0..* | BackboneElement | Population criteria
Slices for extension |  |  |  | Content/Rules for all slices
extension:linkId | S | 1..1 | string | Unique id of the population URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
extension:supportingEvidenceDefinition | S | 0..1 | ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition]] | Extension URL: http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition
code | S | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
description | S | 0..1 | string | The human readable description of this population criteria
stratifier | S | 0..* | BackboneElement | Stratifier criteria for the measure
Slices for extension |  |  |  | Content/Rules for all slices
extension:appliesTo |  | 0..* | CodeableConcept | Which population does this stratifier apply to? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo Binding: MeasurePopulationType (extensible): Indicates the population
extension:linkId | S | 1..1 | string | Unique id of the stratifier URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId
extension:valueSet |  | 0..1 | canonical(ValueSet) | What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
code | S | 0..1 | CodeableConcept | Meaning of the stratifier Binding: Measure Stratifier Type (preferred)
description | S | 0..1 | string | The human readable description of this stratifier
component | S | 0..* | BackboneElement | Stratifier criteria component for the measure
Slices for extension |  |  |  | Content/Rules for all slices
extension:linkId | S | 1..1 | string | Unique id of the stratifier component URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.component.linkId
extension:valueSet |  | 0..1 | canonical(ValueSet) | What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
code | S | 0..1 | CodeableConcept | Meaning of the stratifier component Binding: Measure Stratifier Type (preferred)
description | S | 0..1 | string | The human readable description of this stratifier component
supplementalData | S | 0..* | BackboneElement | What other data should be reported with the measure
Slices for extension |  |  |  | Content/Rules for all slices
extension:linkId | S | 1..1 | string | Unique id of the supplemental data URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
extension:valueSet |  | 0..1 | canonical(ValueSet) | What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
code | S | 0..1 | CodeableConcept | Meaning of the supplemental data
usage | S | 0..* | CodeableConcept | supplemental-data | risk-adjustment-factor
description | S | 0..1 | string | The human readable description of this supplemental data
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Measure.subject[x] | Base | extensible | Subject Type Value Set | 📦4.0.0 | This IG
Measure.scoring | Base | extensible | Measure Scoring | 📦2.0.0 | THO v7.1
Measure.type | Base | extensible | ObservationMeasureType | 📦3.0.0 | THO v7.1
Measure.improvementNotation | Base | required | MeasureImprovementNotation | 📦1.0.1 | THO v7.1
Measure.group.stratifier.​code | Base | preferred | Measure Stratifier Type | 📦1.0.0 | This IG
Measure.group.stratifier.​component.code | Base | preferred | Measure Stratifier Type | 📦1.0.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
comp-1 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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()`
comp-8 | error | Measure.group | 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 | error | Measure.group | 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()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Measure | S C | 0..* | Measure | A quality measure definition Constraints: mea-0, mea-1, comp-1, comp-2, comp-3, comp-4, comp-5, comp-6, comp-7
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:populationBasis | S C | 0..* | code, DataRequirement | What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population Constraints: popBasis-1
extension:scoringUnit | S C | 0..1 | CodeableConcept | What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:effectiveDataRequirements | S | 0..1 | canonical(CRMI Module Definition Library) | Effective required data for evaluation URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
extension:scoringPrecision |  | 0..1 | positiveInt | Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
extension:reportingTiming |  | 0..1 | CQMDataTypeTiming | When and how often the measure should be reported URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-reportingTiming
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
url | Σ | 0..1 | uri | Canonical identifier for this measure, represented as a URI (globally unique)
identifier | Σ | 0..* | Identifier | Additional identifier for the measure
version | Σ | 0..1 | string | Business version of the measure
name | Σ C | 0..1 | string | Name for this measure (computer friendly)
title | Σ | 0..1 | string | Name for this measure (human friendly)
subtitle |  | 0..1 | string | Subordinate title of the measure
status | ?!Σ | 1..1 | code | draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
experimental | Σ | 0..1 | boolean | For testing purposes, not real usage
subject[x] | S | 0..1 |  | E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: Subject Type Value Set (extensible)
subjectCodeableConcept |  |  | CodeableConcept |
subjectReference |  |  | Reference(Group) |
date | Σ | 0..1 | dateTime | Date last changed
publisher | Σ | 0..1 | string | Name of the publisher (organization or individual)
contact | Σ | 0..* | ContactDetail | Contact details for the publisher
description | Σ | 0..1 | markdown | Natural language description of the measure
useContext | Σ | 0..* | UsageContext | The context that the content is intended to support
jurisdiction | Σ | 0..* | CodeableConcept | Intended jurisdiction for measure (if applicable) Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.
purpose |  | 0..1 | markdown | Why this measure is defined
usage | S | 0..1 | string | Describes the clinical usage of the measure
copyright |  | 0..1 | markdown | Use and/or publishing restrictions
approvalDate |  | 0..1 | date | When the measure was approved by publisher
lastReviewDate |  | 0..1 | date | When the measure was last reviewed
effectivePeriod | Σ | 0..1 | Period | When the measure is expected to be used
topic |  | 0..* | CodeableConcept | The category of the measure, such as Education, Treatment, Assessment, etc. Binding: DefinitionTopic (example): High-level categorization of the definition, used for searching, sorting, and filtering.
author |  | 0..* | ContactDetail | Who authored the content
editor |  | 0..* | ContactDetail | Who edited the content
reviewer |  | 0..* | ContactDetail | Who reviewed the content
endorser |  | 0..* | ContactDetail | Who endorsed the content
relatedArtifact |  | 0..* | RelatedArtifact | Additional documentation, citations, etc.
library | S | 0..1 | canonical(CRMI Computable Library) | Logic used by the measure
disclaimer | Σ | 0..1 | markdown | Disclaimer for use of the measure or its referenced content
scoring | S Σ C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort Binding: Measure Scoring (extensible)
compositeScoring | Σ | 0..1 | CodeableConcept | opportunity | all-or-nothing | linear | weighted Binding: CompositeMeasureScoring (extensible): The composite scoring method of the measure.
type | S Σ C | 0..* | CodeableConcept | 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. Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
riskAdjustment | Σ C | 0..1 | string | How risk adjustment is applied for this measure
rateAggregation | Σ C | 0..1 | string | How is rate aggregation performed for this measure
rationale | Σ | 0..1 | markdown | Detailed description of why the measure exists
clinicalRecommendationStatement | Σ | 0..1 | markdown | Summary of clinical guidelines
improvementNotation | S Σ C | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required)
definition | Σ | 0..* | markdown | Defined terms used in the measure documentation
guidance | Σ | 0..1 | markdown | Additional guidance for implementers
group | S C | 0..* | BackboneElement | Population criteria group Constraints: comp-8, comp-9
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the group URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId
extension:populationBasis | S C | 0..1 | code, DataRequirement | What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population Constraints: popBasis-1
extension:scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring Binding: Measure Scoring (extensible): How the measure calculation is performed
extension:scoringUnit | S C | 0..1 | CodeableConcept | What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:scoringPrecision |  | 0..1 | positiveInt | Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
extension:compositeScoring | S | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
extension:component | S | 0..* | RelatedArtifact | What artifact URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
extension:type | C | 0..* | CodeableConcept | Extension URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
extension:riskAdjustment | C | 0..1 | string | How risk adjustment is applied for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
extension:rateAggregation | C | 0..1 | string | How is rate aggregation performed for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
extension:improvementNotation | S C | 0..1 | CodeableConcept | increase | decrease URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | Meaning of the group
description | S | 0..1 | string | Summary description
population | S | 0..* | BackboneElement | Population criteria
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the population URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
extension:supportingEvidenceDefinition | S | 0..1 | ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition]] | Extension URL: http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population.
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
stratifier | S | 0..* | BackboneElement | Stratifier criteria for the measure
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:appliesTo |  | 0..* | CodeableConcept | Which population does this stratifier apply to? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo Binding: MeasurePopulationType (extensible): Indicates the population
extension:linkId | S | 1..1 | string | Unique id of the stratifier URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId
extension:valueSet |  | 0..1 | canonical(ValueSet) | What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | Meaning of the stratifier Binding: Measure Stratifier Type (preferred)
description | S | 0..1 | string | The human readable description of this stratifier
criteria |  | 0..1 | Expression | How the measure should be stratified
component | S | 0..* | BackboneElement | Stratifier criteria component for the measure
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the stratifier component URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.component.linkId
extension:valueSet |  | 0..1 | canonical(ValueSet) | What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | Meaning of the stratifier component Binding: Measure Stratifier Type (preferred)
description | S | 0..1 | string | The human readable description of this stratifier component
criteria |  | 1..1 | Expression | Component of how the measure should be stratified
supplementalData | S | 0..* | BackboneElement | What other data should be reported with the measure
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the supplemental data URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
extension:valueSet |  | 0..1 | canonical(ValueSet) | What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | Meaning of the supplemental data
usage | S | 0..* | CodeableConcept | supplemental-data | risk-adjustment-factor Binding: MeasureDataUsage (extensible): The intended usage for supplemental data elements in the measure.
description | S | 0..1 | string | The human readable description of this supplemental data
criteria |  | 1..1 | Expression | Expression describing additional data to be reported
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Measure.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Measure.status | Base | required | PublicationStatus | 📍4.0.1 | FHIR Std.
Measure.subject[x] | Base | extensible | Subject Type Value Set | 📦4.0.0 | This IG
Measure.jurisdiction | Base | extensible | Jurisdiction | 📍4.0.1 | FHIR Std.
Measure.topic | Base | example | DefinitionTopic | 📍4.0.1 | FHIR Std.
Measure.scoring | Base | extensible | Measure Scoring | 📦2.0.0 | THO v7.1
Measure.compositeScoring | Base | extensible | CompositeMeasureScoring | 📍4.0.1 | FHIR Std.
Measure.type | Base | extensible | ObservationMeasureType | 📦3.0.0 | THO v7.1
Measure.improvementNotation | Base | required | MeasureImprovementNotation | 📦1.0.1 | THO v7.1
Measure.group.population.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.stratifier.​code | Base | preferred | Measure Stratifier Type | 📦1.0.0 | This IG
Measure.group.stratifier.​component.code | Base | preferred | Measure Stratifier Type | 📦1.0.0 | This IG
Measure.supplementalData.​usage | Base | extensible | MeasureDataUsage | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
comp-1 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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()`
comp-8 | error | Measure.group | 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 | error | Measure.group | 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()`
dom-2 | error | Measure | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Measure | 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 | error | Measure | 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 | error | Measure | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Measure | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mea-0 | warning | Measure | 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 | error | Measure | Stratifier SHALL be either a single criteria or a set of criteria components | `group.stratifier.all((code | description | criteria).exists() xor component.exists())`
popBasis-1 | error | Measure.extension:populationBasis, Measure.group.extension:populationBasis | 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())`

Summary

Mandatory: 0 element(5 nested mandatory elements)
Must-Support: 37 elements

Structures

This structure refers to these other structures:

- CRMI Computable Library (http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-computablelibrary)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
- http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-reportingTiming
- http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation
- http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
- Unable to summarise extension http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition (no extension found)
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo
- http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
- http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.component.linkId
- http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId

Maturity: 4

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Measure | S C | 0..* | Measure | A quality measure definition Constraints: mea-0, mea-1, comp-1, comp-2, comp-3, comp-4, comp-5, comp-6, comp-7
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:populationBasis | S C | 0..* | code, DataRequirement | What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population Constraints: popBasis-1
extension:scoringUnit | S C | 0..1 | CodeableConcept | What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:effectiveDataRequirements | S | 0..1 | canonical(CRMI Module Definition Library) | Effective required data for evaluation URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
extension:scoringPrecision |  | 0..1 | positiveInt | Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
extension:reportingTiming |  | 0..1 | CQMDataTypeTiming | When and how often the measure should be reported URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-reportingTiming
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
subject[x] | S | 0..1 |  | E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: Subject Type Value Set (extensible)
subjectCodeableConcept |  |  | CodeableConcept |
subjectReference |  |  | Reference(Group) |
usage | S | 0..1 | string | Describes the clinical usage of the measure
library | S | 0..1 | canonical(CRMI Computable Library) | Logic used by the measure
scoring | S Σ C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort Binding: Measure Scoring (extensible)
type | S Σ C | 0..* | CodeableConcept | 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. Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
riskAdjustment | Σ C | 0..1 | string | How risk adjustment is applied for this measure
rateAggregation | Σ C | 0..1 | string | How is rate aggregation performed for this measure
improvementNotation | S Σ C | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required)
group | S C | 0..* | BackboneElement | Population criteria group Constraints: comp-8, comp-9
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the group URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId
extension:populationBasis | S C | 0..1 | code, DataRequirement | What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population Constraints: popBasis-1
extension:scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring Binding: Measure Scoring (extensible): How the measure calculation is performed
extension:scoringUnit | S C | 0..1 | CodeableConcept | What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:scoringPrecision |  | 0..1 | positiveInt | Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
extension:compositeScoring | S | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
extension:component | S | 0..* | RelatedArtifact | What artifact URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
extension:type | C | 0..* | CodeableConcept | Extension URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
extension:riskAdjustment | C | 0..1 | string | How risk adjustment is applied for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
extension:rateAggregation | C | 0..1 | string | How is rate aggregation performed for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
extension:improvementNotation | S C | 0..1 | CodeableConcept | increase | decrease URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | Meaning of the group
description | S | 0..1 | string | Summary description
population | S | 0..* | BackboneElement | Population criteria
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the population URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
extension:supportingEvidenceDefinition | S | 0..1 | ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition]] | Extension URL: http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population.
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
stratifier | S | 0..* | BackboneElement | Stratifier criteria for the measure
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:appliesTo |  | 0..* | CodeableConcept | Which population does this stratifier apply to? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo Binding: MeasurePopulationType (extensible): Indicates the population
extension:linkId | S | 1..1 | string | Unique id of the stratifier URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId
extension:valueSet |  | 0..1 | canonical(ValueSet) | What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | Meaning of the stratifier Binding: Measure Stratifier Type (preferred)
description | S | 0..1 | string | The human readable description of this stratifier
component | S | 0..* | BackboneElement | Stratifier criteria component for the measure
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the stratifier component URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.component.linkId
extension:valueSet |  | 0..1 | canonical(ValueSet) | What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | Meaning of the stratifier component Binding: Measure Stratifier Type (preferred)
description | S | 0..1 | string | The human readable description of this stratifier component
criteria |  | 1..1 | Expression | Component of how the measure should be stratified
supplementalData | S | 0..* | BackboneElement | What other data should be reported with the measure
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the supplemental data URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
extension:valueSet |  | 0..1 | canonical(ValueSet) | What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | Meaning of the supplemental data
usage | S | 0..* | CodeableConcept | supplemental-data | risk-adjustment-factor Binding: MeasureDataUsage (extensible): The intended usage for supplemental data elements in the measure.
description | S | 0..1 | string | The human readable description of this supplemental data
criteria |  | 1..1 | Expression | Expression describing additional data to be reported
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Measure.status | Base | required | PublicationStatus | 📍4.0.1 | FHIR Std.
Measure.subject[x] | Base | extensible | Subject Type Value Set | 📦4.0.0 | This IG
Measure.scoring | Base | extensible | Measure Scoring | 📦2.0.0 | THO v7.1
Measure.type | Base | extensible | ObservationMeasureType | 📦3.0.0 | THO v7.1
Measure.improvementNotation | Base | required | MeasureImprovementNotation | 📦1.0.1 | THO v7.1
Measure.group.population.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.stratifier.​code | Base | preferred | Measure Stratifier Type | 📦1.0.0 | This IG
Measure.group.stratifier.​component.code | Base | preferred | Measure Stratifier Type | 📦1.0.0 | This IG
Measure.supplementalData.​usage | Base | extensible | MeasureDataUsage | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
comp-1 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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()`
comp-8 | error | Measure.group | 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 | error | Measure.group | 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()`
dom-2 | error | Measure | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Measure | 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 | error | Measure | 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 | error | Measure | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Measure | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mea-0 | warning | Measure | 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 | error | Measure | Stratifier SHALL be either a single criteria or a set of criteria components | `group.stratifier.all((code | description | criteria).exists() xor component.exists())`
popBasis-1 | error | Measure.extension:populationBasis, Measure.group.extension:populationBasis | 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())`

Differential View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Measure | S C | 0..* | Measure | A quality measure definition Constraints: comp-1, comp-2, comp-3, comp-4, comp-5, comp-6, comp-7
Slices for extension |  |  |  | Content/Rules for all slices
extension:populationBasis | S C | 0..* | code, DataRequirement | What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
extension:scoringUnit | S C | 0..1 | CodeableConcept | What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:effectiveDataRequirements | S | 0..1 | canonical(CRMI Module Definition Library) | Effective required data for evaluation URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
extension:scoringPrecision |  | 0..1 | positiveInt | Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
extension:reportingTiming |  | 0..1 | CQMDataTypeTiming | When and how often the measure should be reported URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-reportingTiming
subject[x] | S | 0..1 | CodeableConcept, Reference(Group) | E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: Subject Type Value Set (extensible)
usage | S | 0..1 | string | Describes the clinical usage of the measure
library | S | 0..1 | canonical(CRMI Computable Library) | Logic used by the measure
scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort Binding: Measure Scoring (extensible)
type | S Σ C | 0..* | CodeableConcept | 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. Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
riskAdjustment | C | 0..1 | string | How risk adjustment is applied for this measure
rateAggregation | C | 0..1 | string | How is rate aggregation performed for this measure
improvementNotation | S C | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required)
group | S C | 0..* | BackboneElement | Population criteria group Constraints: comp-8, comp-9
Slices for extension |  |  |  | Content/Rules for all slices
extension:linkId | S | 1..1 | string | Unique id of the group URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId
extension:populationBasis | S C | 0..1 | code, DataRequirement | What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
extension:scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring Binding: Measure Scoring (extensible): How the measure calculation is performed
extension:scoringUnit | S C | 0..1 | CodeableConcept | What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:scoringPrecision |  | 0..1 | positiveInt | Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
extension:compositeScoring | S | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
extension:component | S | 0..* | RelatedArtifact | What artifact URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
extension:type | C | 0..* | CodeableConcept | Extension URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
extension:riskAdjustment | C | 0..1 | string | How risk adjustment is applied for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
extension:rateAggregation | C | 0..1 | string | How is rate aggregation performed for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
extension:improvementNotation | S C | 0..1 | CodeableConcept | increase | decrease URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure
code | S | 0..1 | CodeableConcept | Meaning of the group
description | S | 0..1 | string | Summary description
population | S | 0..* | BackboneElement | Population criteria
Slices for extension |  |  |  | Content/Rules for all slices
extension:linkId | S | 1..1 | string | Unique id of the population URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
extension:supportingEvidenceDefinition | S | 0..1 | ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition]] | Extension URL: http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition
code | S | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
description | S | 0..1 | string | The human readable description of this population criteria
stratifier | S | 0..* | BackboneElement | Stratifier criteria for the measure
Slices for extension |  |  |  | Content/Rules for all slices
extension:appliesTo |  | 0..* | CodeableConcept | Which population does this stratifier apply to? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo Binding: MeasurePopulationType (extensible): Indicates the population
extension:linkId | S | 1..1 | string | Unique id of the stratifier URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId
extension:valueSet |  | 0..1 | canonical(ValueSet) | What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
code | S | 0..1 | CodeableConcept | Meaning of the stratifier Binding: Measure Stratifier Type (preferred)
description | S | 0..1 | string | The human readable description of this stratifier
component | S | 0..* | BackboneElement | Stratifier criteria component for the measure
Slices for extension |  |  |  | Content/Rules for all slices
extension:linkId | S | 1..1 | string | Unique id of the stratifier component URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.component.linkId
extension:valueSet |  | 0..1 | canonical(ValueSet) | What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
code | S | 0..1 | CodeableConcept | Meaning of the stratifier component Binding: Measure Stratifier Type (preferred)
description | S | 0..1 | string | The human readable description of this stratifier component
supplementalData | S | 0..* | BackboneElement | What other data should be reported with the measure
Slices for extension |  |  |  | Content/Rules for all slices
extension:linkId | S | 1..1 | string | Unique id of the supplemental data URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
extension:valueSet |  | 0..1 | canonical(ValueSet) | What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
code | S | 0..1 | CodeableConcept | Meaning of the supplemental data
usage | S | 0..* | CodeableConcept | supplemental-data | risk-adjustment-factor
description | S | 0..1 | string | The human readable description of this supplemental data
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Measure.subject[x] | Base | extensible | Subject Type Value Set | 📦4.0.0 | This IG
Measure.scoring | Base | extensible | Measure Scoring | 📦2.0.0 | THO v7.1
Measure.type | Base | extensible | ObservationMeasureType | 📦3.0.0 | THO v7.1
Measure.improvementNotation | Base | required | MeasureImprovementNotation | 📦1.0.1 | THO v7.1
Measure.group.stratifier.​code | Base | preferred | Measure Stratifier Type | 📦1.0.0 | This IG
Measure.group.stratifier.​component.code | Base | preferred | Measure Stratifier Type | 📦1.0.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
comp-1 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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()`
comp-8 | error | Measure.group | 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 | error | Measure.group | 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()`

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Measure | S C | 0..* | Measure | A quality measure definition Constraints: mea-0, mea-1, comp-1, comp-2, comp-3, comp-4, comp-5, comp-6, comp-7
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:populationBasis | S C | 0..* | code, DataRequirement | What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population Constraints: popBasis-1
extension:scoringUnit | S C | 0..1 | CodeableConcept | What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:effectiveDataRequirements | S | 0..1 | canonical(CRMI Module Definition Library) | Effective required data for evaluation URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
extension:scoringPrecision |  | 0..1 | positiveInt | Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
extension:reportingTiming |  | 0..1 | CQMDataTypeTiming | When and how often the measure should be reported URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-reportingTiming
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
url | Σ | 0..1 | uri | Canonical identifier for this measure, represented as a URI (globally unique)
identifier | Σ | 0..* | Identifier | Additional identifier for the measure
version | Σ | 0..1 | string | Business version of the measure
name | Σ C | 0..1 | string | Name for this measure (computer friendly)
title | Σ | 0..1 | string | Name for this measure (human friendly)
subtitle |  | 0..1 | string | Subordinate title of the measure
status | ?!Σ | 1..1 | code | draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
experimental | Σ | 0..1 | boolean | For testing purposes, not real usage
subject[x] | S | 0..1 |  | E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: Subject Type Value Set (extensible)
subjectCodeableConcept |  |  | CodeableConcept |
subjectReference |  |  | Reference(Group) |
date | Σ | 0..1 | dateTime | Date last changed
publisher | Σ | 0..1 | string | Name of the publisher (organization or individual)
contact | Σ | 0..* | ContactDetail | Contact details for the publisher
description | Σ | 0..1 | markdown | Natural language description of the measure
useContext | Σ | 0..* | UsageContext | The context that the content is intended to support
jurisdiction | Σ | 0..* | CodeableConcept | Intended jurisdiction for measure (if applicable) Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.
purpose |  | 0..1 | markdown | Why this measure is defined
usage | S | 0..1 | string | Describes the clinical usage of the measure
copyright |  | 0..1 | markdown | Use and/or publishing restrictions
approvalDate |  | 0..1 | date | When the measure was approved by publisher
lastReviewDate |  | 0..1 | date | When the measure was last reviewed
effectivePeriod | Σ | 0..1 | Period | When the measure is expected to be used
topic |  | 0..* | CodeableConcept | The category of the measure, such as Education, Treatment, Assessment, etc. Binding: DefinitionTopic (example): High-level categorization of the definition, used for searching, sorting, and filtering.
author |  | 0..* | ContactDetail | Who authored the content
editor |  | 0..* | ContactDetail | Who edited the content
reviewer |  | 0..* | ContactDetail | Who reviewed the content
endorser |  | 0..* | ContactDetail | Who endorsed the content
relatedArtifact |  | 0..* | RelatedArtifact | Additional documentation, citations, etc.
library | S | 0..1 | canonical(CRMI Computable Library) | Logic used by the measure
disclaimer | Σ | 0..1 | markdown | Disclaimer for use of the measure or its referenced content
scoring | S Σ C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort Binding: Measure Scoring (extensible)
compositeScoring | Σ | 0..1 | CodeableConcept | opportunity | all-or-nothing | linear | weighted Binding: CompositeMeasureScoring (extensible): The composite scoring method of the measure.
type | S Σ C | 0..* | CodeableConcept | 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. Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
riskAdjustment | Σ C | 0..1 | string | How risk adjustment is applied for this measure
rateAggregation | Σ C | 0..1 | string | How is rate aggregation performed for this measure
rationale | Σ | 0..1 | markdown | Detailed description of why the measure exists
clinicalRecommendationStatement | Σ | 0..1 | markdown | Summary of clinical guidelines
improvementNotation | S Σ C | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required)
definition | Σ | 0..* | markdown | Defined terms used in the measure documentation
guidance | Σ | 0..1 | markdown | Additional guidance for implementers
group | S C | 0..* | BackboneElement | Population criteria group Constraints: comp-8, comp-9
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the group URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId
extension:populationBasis | S C | 0..1 | code, DataRequirement | What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population Constraints: popBasis-1
extension:scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring Binding: Measure Scoring (extensible): How the measure calculation is performed
extension:scoringUnit | S C | 0..1 | CodeableConcept | What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:scoringPrecision |  | 0..1 | positiveInt | Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
extension:compositeScoring | S | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
extension:component | S | 0..* | RelatedArtifact | What artifact URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
extension:type | C | 0..* | CodeableConcept | Extension URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
extension:riskAdjustment | C | 0..1 | string | How risk adjustment is applied for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
extension:rateAggregation | C | 0..1 | string | How is rate aggregation performed for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
extension:improvementNotation | S C | 0..1 | CodeableConcept | increase | decrease URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | Meaning of the group
description | S | 0..1 | string | Summary description
population | S | 0..* | BackboneElement | Population criteria
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the population URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
extension:supportingEvidenceDefinition | S | 0..1 | ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition]] | Extension URL: http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population.
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
stratifier | S | 0..* | BackboneElement | Stratifier criteria for the measure
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:appliesTo |  | 0..* | CodeableConcept | Which population does this stratifier apply to? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo Binding: MeasurePopulationType (extensible): Indicates the population
extension:linkId | S | 1..1 | string | Unique id of the stratifier URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId
extension:valueSet |  | 0..1 | canonical(ValueSet) | What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | Meaning of the stratifier Binding: Measure Stratifier Type (preferred)
description | S | 0..1 | string | The human readable description of this stratifier
criteria |  | 0..1 | Expression | How the measure should be stratified
component | S | 0..* | BackboneElement | Stratifier criteria component for the measure
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the stratifier component URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.component.linkId
extension:valueSet |  | 0..1 | canonical(ValueSet) | What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | Meaning of the stratifier component Binding: Measure Stratifier Type (preferred)
description | S | 0..1 | string | The human readable description of this stratifier component
criteria |  | 1..1 | Expression | Component of how the measure should be stratified
supplementalData | S | 0..* | BackboneElement | What other data should be reported with the measure
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the supplemental data URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
extension:valueSet |  | 0..1 | canonical(ValueSet) | What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | Meaning of the supplemental data
usage | S | 0..* | CodeableConcept | supplemental-data | risk-adjustment-factor Binding: MeasureDataUsage (extensible): The intended usage for supplemental data elements in the measure.
description | S | 0..1 | string | The human readable description of this supplemental data
criteria |  | 1..1 | Expression | Expression describing additional data to be reported
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Measure.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Measure.status | Base | required | PublicationStatus | 📍4.0.1 | FHIR Std.
Measure.subject[x] | Base | extensible | Subject Type Value Set | 📦4.0.0 | This IG
Measure.jurisdiction | Base | extensible | Jurisdiction | 📍4.0.1 | FHIR Std.
Measure.topic | Base | example | DefinitionTopic | 📍4.0.1 | FHIR Std.
Measure.scoring | Base | extensible | Measure Scoring | 📦2.0.0 | THO v7.1
Measure.compositeScoring | Base | extensible | CompositeMeasureScoring | 📍4.0.1 | FHIR Std.
Measure.type | Base | extensible | ObservationMeasureType | 📦3.0.0 | THO v7.1
Measure.improvementNotation | Base | required | MeasureImprovementNotation | 📦1.0.1 | THO v7.1
Measure.group.population.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.stratifier.​code | Base | preferred | Measure Stratifier Type | 📦1.0.0 | This IG
Measure.group.stratifier.​component.code | Base | preferred | Measure Stratifier Type | 📦1.0.0 | This IG
Measure.supplementalData.​usage | Base | extensible | MeasureDataUsage | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
comp-1 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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 | error | Measure | 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()`
comp-8 | error | Measure.group | 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 | error | Measure.group | 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()`
dom-2 | error | Measure | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Measure | 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 | error | Measure | 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 | error | Measure | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Measure | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mea-0 | warning | Measure | 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 | error | Measure | Stratifier SHALL be either a single criteria or a set of criteria components | `group.stratifier.all((code | description | criteria).exists() xor component.exists())`
popBasis-1 | error | Measure.extension:populationBasis, Measure.group.extension:populationBasis | 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())`

Summary

Mandatory: 0 element(5 nested mandatory elements)
Must-Support: 37 elements

Structures

This structure refers to these other structures:

- CRMI Computable Library (http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-computablelibrary)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
- http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-reportingTiming
- http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation
- http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
- Unable to summarise extension http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidenceDefinition (no extension found)
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo
- http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
- http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.component.linkId
- http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId

Maturity: 4

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