Quality Measure Implementation Guide
2.0.0-ballot - STU 2 Ballot

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

## Resource Profile: CQM Ratio Measure

Official URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-ratiomeasure | Version: 1.0.0 | Highlight text changes?
Standards status: Trial-use Active as of 2026-04-07 | Maturity Level: 4 | Computable Name: CQMRatioMeasure
Other Identifiers: OID:2.16.840.1.113883.4.642.40.61.42.25

The CQM Ratio Measure Profile describes a ratio scoring measure. For more information on the usage of this profile, refer to the Profiles and Packaging pages in this implementation guide.

Usages:

- Examples for this Profile: EXMRatioMeasure
- 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..* | CQMComputableMeasure | 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 | ratio Binding: Measure Scoring (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: ratio
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
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.
improvementNotation | S Σ C | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required)
group | S C | 1..* | BackboneElement | Population criteria group Constraints: comp-8, comp-9, cmp-13
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
Slices for population | S C | 4..8 | BackboneElement | Population criteria Slice: Unordered, Open by value:code
population:All Slices |  |  |  | Content/Rules for all slices
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
population:initialPopulation | S | 1..2 | BackboneElement | Initial Population
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
extension:populationBasis |  | 0..* | code, DataRequirement | Allows the populationBasis for that population to be overridden. If not present, the populationBasis of the measure (or group) is used. If present, it specifies the population basis for all the expressions that use it as the initial population in the ratio measure. URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: initial-population
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:denominator | S | 1..1 | BackboneElement | Denominator
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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: denominator
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:denominatorExclusion | S | 0..1 | BackboneElement | Denominator Exclusion
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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: denominator-exclusion
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:numerator | S | 1..1 | BackboneElement | Numerator
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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: numerator
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:numeratorExclusion | S | 0..1 | BackboneElement | Numerator Exclusion
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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: numerator-exclusion
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:measureObservation | S | 0..2 | BackboneElement | Measure Observation
Slices for extension |  | 2..* | 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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
extension:aggregateMethod | S | 1..1 | code | Aggregate with URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-aggregateMethod Binding: Measure Aggregate Method (preferred): Aggregation method for a measure (e.g. sum, average, median, minimum, maximum, count)
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: measure-observation
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
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.population:initialPopulation.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:denominator.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:denominatorExclusion.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:numerator.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:numeratorExclusion.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:measureObservation.​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
cmp-13 | error | Measure.group | Ratio measures may not have other than initial population, denominator, numerator, denominator-exclusion, numerator-exclusion, and measure-observation criteria | `extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'ratio' implies population.select(code.coding.where(system = 'http://terminology.hl7.org/CodeSystem/measure-population').code in ('initial-population' | 'numerator' | 'denominator' | 'denominator-exclusion' | 'measure-observation' | 'numerator-exclusion')).allTrue()`
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 |  | 0..* | CQMComputableMeasure | A quality measure definition
scoring | S | 0..1 | CodeableConcept | ratio Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: ratio
group | S C | 1..* | BackboneElement | Population criteria group Constraints: cmp-13
Slices for extension |  |  |  | Content/Rules for all slices
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
Slices for population | S C | 4..8 | BackboneElement | Population criteria Slice: Unordered, Open by value:code
population:initialPopulation | S | 1..2 | BackboneElement | Initial Population
Slices for extension |  |  |  | Content/Rules for all slices
extension:populationBasis |  | 0..* | code, DataRequirement | Allows the populationBasis for that population to be overridden. If not present, the populationBasis of the measure (or group) is used. If present, it specifies the population basis for all the expressions that use it as the initial population in the ratio measure. URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: initial-population
population:denominator | S | 1..1 | BackboneElement | Denominator
Slices for extension |  |  |  | Content/Rules for all slices
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: denominator
population:denominatorExclusion | S | 0..1 | BackboneElement | Denominator Exclusion
Slices for extension |  |  |  | Content/Rules for all slices
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: denominator-exclusion
population:numerator | S | 1..1 | BackboneElement | Numerator
Slices for extension |  |  |  | Content/Rules for all slices
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: numerator
population:numeratorExclusion | S | 0..1 | BackboneElement | Numerator Exclusion
Slices for extension |  |  |  | Content/Rules for all slices
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: numerator-exclusion
population:measureObservation | S | 0..2 | BackboneElement | Measure Observation
Slices for extension |  |  |  | Content/Rules for all slices
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
extension:aggregateMethod | S | 1..1 | code | Aggregate with URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-aggregateMethod Binding: Measure Aggregate Method (preferred): Aggregation method for a measure (e.g. sum, average, median, minimum, maximum, count)
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: measure-observation
Documentation for this format

#### Constraints

Id | Grade | Path(s) | Description | Expression
cmp-13 | error | Measure.group | Ratio measures may not have other than initial population, denominator, numerator, denominator-exclusion, numerator-exclusion, and measure-observation criteria | `extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'ratio' implies population.select(code.coding.where(system = 'http://terminology.hl7.org/CodeSystem/measure-population').code in ('initial-population' | 'numerator' | 'denominator' | 'denominator-exclusion' | 'measure-observation' | 'numerator-exclusion')).allTrue()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Measure | S C | 0..* | CQMComputableMeasure | 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 | ratio Binding: Measure Scoring (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: ratio
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
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 | 1..* | BackboneElement | Population criteria group Constraints: comp-8, comp-9, cmp-13
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
Slices for population | S C | 4..8 | BackboneElement | Population criteria Slice: Unordered, Open by value:code
population:All Slices |  |  |  | Content/Rules for all slices
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
population:initialPopulation | S | 1..2 | BackboneElement | Initial Population
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
extension:populationBasis |  | 0..* | code, DataRequirement | Allows the populationBasis for that population to be overridden. If not present, the populationBasis of the measure (or group) is used. If present, it specifies the population basis for all the expressions that use it as the initial population in the ratio measure. URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: initial-population
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:denominator | S | 1..1 | BackboneElement | Denominator
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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: denominator
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:denominatorExclusion | S | 0..1 | BackboneElement | Denominator Exclusion
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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: denominator-exclusion
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:numerator | S | 1..1 | BackboneElement | Numerator
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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: numerator
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:numeratorExclusion | S | 0..1 | BackboneElement | Numerator Exclusion
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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: numerator-exclusion
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:measureObservation | S | 0..2 | BackboneElement | Measure Observation
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 2..* | 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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
extension:aggregateMethod | S | 1..1 | code | Aggregate with URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-aggregateMethod Binding: Measure Aggregate Method (preferred): Aggregation method for a measure (e.g. sum, average, median, minimum, maximum, count)
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: measure-observation
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
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.population:initialPopulation.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:denominator.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:denominatorExclusion.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:numerator.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:numeratorExclusion.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:measureObservation.​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
cmp-13 | error | Measure.group | Ratio measures may not have other than initial population, denominator, numerator, denominator-exclusion, numerator-exclusion, and measure-observation criteria | `extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'ratio' implies population.select(code.coding.where(system = 'http://terminology.hl7.org/CodeSystem/measure-population').code in ('initial-population' | 'numerator' | 'denominator' | 'denominator-exclusion' | 'measure-observation' | 'numerator-exclusion')).allTrue()`
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: 7 elements(4 nested mandatory elements)
Must-Support: 22 elements

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis
- http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-aggregateMethod

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Measure.group.population

Maturity: 4

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Measure | S C | 0..* | CQMComputableMeasure | 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 | ratio Binding: Measure Scoring (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: ratio
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
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.
improvementNotation | S Σ C | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required)
group | S C | 1..* | BackboneElement | Population criteria group Constraints: comp-8, comp-9, cmp-13
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
Slices for population | S C | 4..8 | BackboneElement | Population criteria Slice: Unordered, Open by value:code
population:All Slices |  |  |  | Content/Rules for all slices
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
population:initialPopulation | S | 1..2 | BackboneElement | Initial Population
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
extension:populationBasis |  | 0..* | code, DataRequirement | Allows the populationBasis for that population to be overridden. If not present, the populationBasis of the measure (or group) is used. If present, it specifies the population basis for all the expressions that use it as the initial population in the ratio measure. URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: initial-population
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:denominator | S | 1..1 | BackboneElement | Denominator
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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: denominator
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:denominatorExclusion | S | 0..1 | BackboneElement | Denominator Exclusion
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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: denominator-exclusion
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:numerator | S | 1..1 | BackboneElement | Numerator
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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: numerator
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:numeratorExclusion | S | 0..1 | BackboneElement | Numerator Exclusion
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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: numerator-exclusion
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:measureObservation | S | 0..2 | BackboneElement | Measure Observation
Slices for extension |  | 2..* | 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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
extension:aggregateMethod | S | 1..1 | code | Aggregate with URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-aggregateMethod Binding: Measure Aggregate Method (preferred): Aggregation method for a measure (e.g. sum, average, median, minimum, maximum, count)
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: measure-observation
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
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.population:initialPopulation.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:denominator.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:denominatorExclusion.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:numerator.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:numeratorExclusion.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:measureObservation.​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
cmp-13 | error | Measure.group | Ratio measures may not have other than initial population, denominator, numerator, denominator-exclusion, numerator-exclusion, and measure-observation criteria | `extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'ratio' implies population.select(code.coding.where(system = 'http://terminology.hl7.org/CodeSystem/measure-population').code in ('initial-population' | 'numerator' | 'denominator' | 'denominator-exclusion' | 'measure-observation' | 'numerator-exclusion')).allTrue()`
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 |  | 0..* | CQMComputableMeasure | A quality measure definition
scoring | S | 0..1 | CodeableConcept | ratio Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: ratio
group | S C | 1..* | BackboneElement | Population criteria group Constraints: cmp-13
Slices for extension |  |  |  | Content/Rules for all slices
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
Slices for population | S C | 4..8 | BackboneElement | Population criteria Slice: Unordered, Open by value:code
population:initialPopulation | S | 1..2 | BackboneElement | Initial Population
Slices for extension |  |  |  | Content/Rules for all slices
extension:populationBasis |  | 0..* | code, DataRequirement | Allows the populationBasis for that population to be overridden. If not present, the populationBasis of the measure (or group) is used. If present, it specifies the population basis for all the expressions that use it as the initial population in the ratio measure. URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: initial-population
population:denominator | S | 1..1 | BackboneElement | Denominator
Slices for extension |  |  |  | Content/Rules for all slices
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: denominator
population:denominatorExclusion | S | 0..1 | BackboneElement | Denominator Exclusion
Slices for extension |  |  |  | Content/Rules for all slices
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: denominator-exclusion
population:numerator | S | 1..1 | BackboneElement | Numerator
Slices for extension |  |  |  | Content/Rules for all slices
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: numerator
population:numeratorExclusion | S | 0..1 | BackboneElement | Numerator Exclusion
Slices for extension |  |  |  | Content/Rules for all slices
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: numerator-exclusion
population:measureObservation | S | 0..2 | BackboneElement | Measure Observation
Slices for extension |  |  |  | Content/Rules for all slices
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
extension:aggregateMethod | S | 1..1 | code | Aggregate with URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-aggregateMethod Binding: Measure Aggregate Method (preferred): Aggregation method for a measure (e.g. sum, average, median, minimum, maximum, count)
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: measure-observation
Documentation for this format

#### Constraints

Id | Grade | Path(s) | Description | Expression
cmp-13 | error | Measure.group | Ratio measures may not have other than initial population, denominator, numerator, denominator-exclusion, numerator-exclusion, and measure-observation criteria | `extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'ratio' implies population.select(code.coding.where(system = 'http://terminology.hl7.org/CodeSystem/measure-population').code in ('initial-population' | 'numerator' | 'denominator' | 'denominator-exclusion' | 'measure-observation' | 'numerator-exclusion')).allTrue()`

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Measure | S C | 0..* | CQMComputableMeasure | 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 | ratio Binding: Measure Scoring (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: ratio
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
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 | 1..* | BackboneElement | Population criteria group Constraints: comp-8, comp-9, cmp-13
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
Slices for population | S C | 4..8 | BackboneElement | Population criteria Slice: Unordered, Open by value:code
population:All Slices |  |  |  | Content/Rules for all slices
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
population:initialPopulation | S | 1..2 | BackboneElement | Initial Population
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
extension:populationBasis |  | 0..* | code, DataRequirement | Allows the populationBasis for that population to be overridden. If not present, the populationBasis of the measure (or group) is used. If present, it specifies the population basis for all the expressions that use it as the initial population in the ratio measure. URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: initial-population
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:denominator | S | 1..1 | BackboneElement | Denominator
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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: denominator
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:denominatorExclusion | S | 0..1 | BackboneElement | Denominator Exclusion
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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: denominator-exclusion
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:numerator | S | 1..1 | BackboneElement | Numerator
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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: numerator
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:numeratorExclusion | S | 0..1 | BackboneElement | Numerator Exclusion
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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: numerator-exclusion
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
description | S | 0..1 | string | The human readable description of this population criteria
criteria |  | 1..1 | Expression | The criteria that defines this population
population:measureObservation | S | 0..2 | BackboneElement | Measure Observation
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 2..* | 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
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
extension:aggregateMethod | S | 1..1 | code | Aggregate with URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-aggregateMethod Binding: Measure Aggregate Method (preferred): Aggregation method for a measure (e.g. sum, average, median, minimum, maximum, count)
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..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. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: measure-observation
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
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.population:initialPopulation.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:denominator.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:denominatorExclusion.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:numerator.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:numeratorExclusion.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
Measure.group.population:measureObservation.​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
cmp-13 | error | Measure.group | Ratio measures may not have other than initial population, denominator, numerator, denominator-exclusion, numerator-exclusion, and measure-observation criteria | `extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code contains 'ratio' implies population.select(code.coding.where(system = 'http://terminology.hl7.org/CodeSystem/measure-population').code in ('initial-population' | 'numerator' | 'denominator' | 'denominator-exclusion' | 'measure-observation' | 'numerator-exclusion')).allTrue()`
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: 7 elements(4 nested mandatory elements)
Must-Support: 22 elements

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis
- http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-aggregateMethod

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Measure.group.population

Maturity: 4

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