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 Publishable Measure - Detailed Descriptions

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

Definitions for the cqm-publishablemeasure resource profile

- Key Elements Table
- Differential Table
- Snapshot Table

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

0. Measure
Definition | The Measure resource provides the definition of a quality measure.
Short | A quality measure definition
Control | 10..1*
Is Modifier | false
Must Support | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) mea-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (`name.matches('[A-Z]([A-Za-z0-9_]){0,254}')`) mea-1: Stratifier SHALL be either a single criteria or a set of criteria components (`group.stratifier.all((code | description | criteria).exists() xor component.exists())`) mea-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}')) mea-1: Stratifier SHALL be either a single criteria or a set of criteria components (group.stratifier.all((code | description | criteria).exists() xor component.exists()))
2. Measure.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Measure.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 10..1
Type | Narrative
Is Modifier | false
Must Support | true
Summary | false
Requirements | A published measure must provide human-readable narrative description of the measure contents.
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Measure.extension:copyrightLabel
Slice Name | copyrightLabel
Definition | A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. (e.g. 'All rights reserved', 'Some rights reserved').
Short | Copyright holder and year(s)
Comments | Defines the content expected to be rendered in all representations of the artifact. The (c) symbol should NOT be included in this string. It is expected to be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.
Control | 0..1
Type | Extension(Artifact Copyright Label) (Extension Type: string)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Measure.extension:renderMissingElements
Slice Name | renderMissingElements
Definition | Indicates whether to render missing elements (including population criteria, stratifiers, and supplemental data elements) in measure narrative. True indicates that missing elements should be rendered with an appropriate indicator (such as None, or N/A) when elements that would be expected to be present are not specified in a measure. For example, the denominator exclusion criteria for a proportion measure will be rendered as None if it is not present in a proportion measure.
Short | Render missing elements?
Comments | If this extension is not present, measure narrative will render as though it is false (i.e. missing elements will not render in the measure narrative)
Control | 0..1
Type | Extension(CQM Render Missing Elements) (Extension Type: boolean)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. Measure.extension:limitations
Slice Name | limitations
Definition | identifies what limitations should be noted, including potential selection biases and confounding factors when interpreting indicator results or comparing results across the country.
Short | Extension
Control | 0..1
Type | Extension(CQM Limitations) (Extension Type: markdown)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. Measure.extension:trendingIssues
Slice Name | trendingIssues
Definition | identifies what issues might affect the interpretation of trending results, including changes in geographic coverage, data quality, coding standards and classification changes (for example, a new ICD standard).
Short | Extension
Control | 0..1
Type | Extension(CQM Trending Issues) (Extension Type: markdown)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. Measure.extension:supplementalDataGuidance
Slice Name | supplementalDataGuidance
Definition | Specifies additional guidance related to the collection and reporting of supplemental data elements defined in the measure.
Short | Supplemental data guidance
Control | 0..*
Type | Extension(CQM Supplemental Data Guidance) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
16. Measure.extension:comment
Slice Name | comment
Definition | A comment containing additional documentation, a review comment, usage guidance, or other relevant information from a particular user.
Short | Additional documentation, review, or usage guidance
Control | 0..*
Type | Extension(Artifact Comment) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. Measure.extension:softwaresystem
Slice Name | softwaresystem
Definition | Specifies the software systems used in the packaging and testing of measure and library resources. Specifically to know which version of what software was used.
Short | Extension
Control | 0..*
Type | Extension(CRMI Software System) (Extension Type: Reference(CRMI Software System Device))
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
20. Measure.extension:improvementNotationGuidance
Slice Name | improvementNotationGuidance
Definition | Additional guidance on how to interpret the improvement notation of the measure.
Short | Explanation of improvement notation
Control | 0..1
Type | Extension(CQF Improvement Notation Guidance) (Extension Type: markdown)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
22. Measure.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
24. Measure.identifier
Definition | A formal identifier that is used to identify this measure when it is represented in other formats, or referenced in a specification, model, design or an instance.
Short | Additional identifier for the measure
Comments | Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this measure outside of FHIR, where it is not possible to use the logical URI.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 30..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | A published measure must be able to specify additional identifiers such as endorser and publisher identifiers for the measure. Allows externally provided and/or usable business identifiers to be easily associated with the module.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Measure.identifier`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ type
26. Measure.identifier:versionIndependentIdentifier
Slice Name | versionIndependentIdentifier
Definition | The version-independent globally unique identifier for the measure (GUID). A formal identifier that is used to identify this measure when it is represented in other formats, or referenced in a specification, model, design or an instance.
Short | Measure guidAdditional identifier for the measure
Comments | Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this measure outside of FHIR, where it is not possible to use the logical URI.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 10..1*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows externally provided and/or usable business identifiers to be easily associated with the module.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Measure.identifier:versionIndependentIdentifier.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 10..1
Binding | The codes SHALL be taken from IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Fixed Value | `official`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Measure.identifier:versionIndependentIdentifier.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/identifier-type|4.0.1` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "version-independent" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. Measure.identifier:versionIndependentIdentifier.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Fixed Value | `urn:ietf:rfc:3986`
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. Measure.identifier:versionIndependentIdentifier.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. Measure.identifier:versionSpecificIdentifier
Slice Name | versionSpecificIdentifier
Definition | The version-specific globally unique identifier for the measure (GUID). A formal identifier that is used to identify this measure when it is represented in other formats, or referenced in a specification, model, design or an instance.
Short | Measure version guidAdditional identifier for the measure
Comments | Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this measure outside of FHIR, where it is not possible to use the logical URI.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 10..1*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows externally provided and/or usable business identifiers to be easily associated with the module.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. Measure.identifier:versionSpecificIdentifier.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 10..1
Binding | The codes SHALL be taken from IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Fixed Value | `official`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Measure.identifier:versionSpecificIdentifier.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/identifier-type|4.0.1` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "version-specific" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. Measure.identifier:versionSpecificIdentifier.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Fixed Value | `urn:ietf:rfc:3986`
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. Measure.identifier:versionSpecificIdentifier.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. Measure.identifier:shortName
Slice Name | shortName
Definition | The short name for the measure (e.g. CMS104v4). A formal identifier that is used to identify this measure when it is represented in other formats, or referenced in a specification, model, design or an instance.
Short | Short nameAdditional identifier for the measure
Comments | Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this measure outside of FHIR, where it is not possible to use the logical URI.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 10..1*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows externally provided and/or usable business identifiers to be easily associated with the module.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. Measure.identifier:shortName.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 10..1
Binding | The codes SHALL be taken from IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Fixed Value | `usual`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. Measure.identifier:shortName.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/identifier-type|4.0.1` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "short-name" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. Measure.identifier:shortName.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. Measure.identifier:endorserIdentifier
Slice Name | endorserIdentifier
Definition | An identifier assigned by the measure endorser. A formal identifier that is used to identify this measure when it is represented in other formats, or referenced in a specification, model, design or an instance.
Short | Endorser identifierAdditional identifier for the measure
Comments | Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this measure outside of FHIR, where it is not possible to use the logical URI.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows externally provided and/or usable business identifiers to be easily associated with the module.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. Measure.identifier:endorserIdentifier.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 10..1
Binding | The codes SHALL be taken from IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Fixed Value | `official`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. Measure.identifier:endorserIdentifier.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/identifier-type|4.0.1` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "endorser" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. Measure.identifier:endorserIdentifier.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. Measure.identifier:endorserIdentifier.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. Measure.identifier:endorserIdentifier.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 10..1
Type | Reference(Organization)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. Measure.identifier:endorserIdentifier.assigner.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Short | Text alternative for the resource
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. Measure.identifier:publisherIdentifier
Slice Name | publisherIdentifier
Definition | An identifier assigned by the measure publisher. A formal identifier that is used to identify this measure when it is represented in other formats, or referenced in a specification, model, design or an instance.
Short | Publisher identifierAdditional identifier for the measure
Comments | Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this measure outside of FHIR, where it is not possible to use the logical URI.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows externally provided and/or usable business identifiers to be easily associated with the module.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. Measure.identifier:publisherIdentifier.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 10..1
Binding | The codes SHALL be taken from IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Fixed Value | `official`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. Measure.identifier:publisherIdentifier.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/identifier-type|4.0.1` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "publisher" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. Measure.identifier:publisherIdentifier.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
76. Measure.identifier:publisherIdentifier.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
78. Measure.identifier:publisherIdentifier.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 10..1
Type | Reference(Organization)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
80. Measure.identifier:publisherIdentifier.assigner.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Short | Text alternative for the resource
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
82. Measure.title
Definition | A short, descriptive, user-friendly title for the measure.
Short | Name for this measure (human friendly)
Comments | This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | A published measure must specify a human-friendly title.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. Measure.status
Definition | The status of this measure. Enables tracking the life-cycle of the content.
Short | draft | active | retired | unknown
Comments | Allows filtering of measures that are appropriate for use versus not.
Control | 1..1
Binding | The codes SHALL be taken from PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/publication-status|4.0.1` ) The lifecycle status of an artifact.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | A published measure must have a status of active.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
86. Measure.date
Definition | The date (and optionally time) when the measure was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the measure changes.
Short | Date last changed
Comments | Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the measure. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.
Control | 10..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | A published measure must specify the date the measure content was last changed.
Alternate Names | Revision Date
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
88. Measure.publisher
Definition | The name of the organization or individual that published the measure.
Short | Name of the publisher (organization or individual)
Comments | Usually an organization but may be an individual. The publisher (or steward) of the measure is the organization or individual primarily responsible for the maintenance and upkeep of the measure. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the measure. This item SHOULD be populated unless the information is available from context.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | A published measure must provide publisher information. Helps establish the "authority/credibility" of the measure. May also allow for contact.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
90. Measure.contact
Definition | Contact details to assist a user in finding and communicating with the publisher.
Short | Contact details for the publisher
Comments | May be a web site, an email address, a telephone number, etc.
Control | 10..*
Type | ContactDetail
Is Modifier | false
Must Support | true
Summary | true
Requirements | A published measure must provide contact information for the publisher.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
92. Measure.useContext
Definition | The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate measure instances.
Short | The context that the content is intended to support
Comments | When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.
Control | 0..*
Type | UsageContext
Is Modifier | false
Must Support | true
Summary | true
Requirements | A published measure must be able to specify intended contexts of use such as intended venue. Assist in searching for appropriate content.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Measure.useContext`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ code
94. Measure.useContext:intendedVenue
Slice Name | intendedVenue
Definition | The intended venue for use for this measure. The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate measure instances.
Short | What venue?The context that the content is intended to support
Comments | When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.
Control | 0..*
Type | UsageContext
Is Modifier | false
Must Support | true
Summary | true
Requirements | Assist in searching for appropriate content.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
96. Measure.useContext:intendedVenue.code
Definition | A code that identifies the type of context being specified by this usage context.
Short | Type of context being specified
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from UsageContextType http://hl7.org/fhir/ValueSet/usage-context-type|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/usage-context-type|4.0.1` ) A code that specifies a type of context being specified by a usage context.
Type | Coding
Is Modifier | false
Must Support | true
Summary | true
Pattern Value | `{ "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type", "code" : "venue" }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
98. Measure.useContext:intendedVenue.value[x]
Definition | A value that defines the context specified in this context of use. The interpretation of the value is defined by the code.
Short | Value that defines the context
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from For example codes, see Intended Venue http://hl7.org/fhir/ValueSet/use-context|4.0.1 (extensible to `http://hl7.org/fhir/uv/cqm/ValueSet/intended-venue` )
Type | CodeableConcept, Reference(PlanDefinition, ResearchStudy, InsurancePlan, HealthcareService, Group, Location, Organization), Quantity, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
100. Measure.jurisdiction
Definition | A legal or geographic region in which the measure is intended to be used.
Short | Intended jurisdiction for measure (if applicable)
Comments | It may be possible for the measure to be used in jurisdictions other than those for which it was originally designed or intended.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from Jurisdiction ValueSet http://hl7.org/fhir/ValueSet/jurisdiction|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/jurisdiction` ) Countries and regions within which this artifact is targeted for use.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. Measure.purpose
Definition | Explanation of why this measure is needed and why it has been designed as it has.
Short | Why this measure is defined
Comments | This element does not describe the usage of the measure. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this measure.
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | A published measure should provide a clear description of the purpose of the measure.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
104. Measure.usage
Definition | A detailed description, from a clinical perspective, of how the measure is used.
Short | Allows measure developers to provide additional guidance so that implementers can more easily interpret and implement components of the measure.Describes the clinical usage of the measure
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | A published measure should provide clinical usage notes for the measure.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
106. Measure.copyright
Definition | A copyright statement relating to the measure and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the measure.
Short | Use and/or publishing restrictions
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | A published measure should provide copyright information for the measure content. Consumers must be able to determine any legal restrictions on the use of the measure and/or its content.
Alternate Names | License, Restrictions
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
108. Measure.approvalDate
Definition | The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.
Short | When the measure was approved by publisher
Comments | The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.
Control | 0..1
Type | date
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | A published measure must indicate the date the measure content was approved by the publisher.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
110. Measure.lastReviewDate
Definition | The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.
Short | When the measure was last reviewed
Comments | If specified, this date follows the original approval date.
Control | 0..1
Type | date
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | A published measure must indicate when the measure content was last reviewed. Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
112. Measure.effectivePeriod
Definition | The period during which the measure content was or is planned to be in active use.
Short | When the measure is expected to be used
Comments | The effective period for a measure determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.
Control | 0..1
Type | Period
Is Modifier | false
Must Support | true
Summary | true
Requirements | A published measure should provide an indication of the period during which the measure content can be effectively applied. Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the measure are or are expected to be used instead.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
114. Measure.effectivePeriod.extension:anchor
Slice Name | anchor
Definition | Specifies the anchor date for the effective period as defined by a starting date and a range.
Short | Date of first effective use
Control | 0..1
Type | Extension(CQM Effective Period Anchor) (Extension Type: dateTime)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
116. Measure.effectivePeriod.extension:duration
Slice Name | duration
Definition | Specifies the reporting period for the measure.
Short | What reporting period is used
Control | 0..1
Type | Extension(CQM Effective Period Duration) (Extension Type: Duration)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
118. Measure.topic
Definition | Descriptive topics related to the content of the measure. Topics provide a high-level categorization grouping types of measures that can be useful for filtering and searching.
Short | The category of the measure, such as Education, Treatment, Assessment, etc.
Control | 0..*
Binding | For example codes, see DefinitionTopic http://hl7.org/fhir/ValueSet/definition-topic|4.0.1 (example to `http://hl7.org/fhir/ValueSet/definition-topic` ) High-level categorization of the definition, used for searching, sorting, and filtering.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Requirements | A published measure should provide relevant topics for the measure content. Repositories must be able to determine how to categorize the measure so that it can be found by topical searches.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
120. Measure.author
Definition | An individiual or organization primarily involved in the creation and maintenance of the content.
Short | Who authored the content
Control | 0..*
Type | ContactDetail
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
122. Measure.editor
Definition | An individual or organization primarily responsible for internal coherence of the content.
Short | Who edited the content
Control | 0..*
Type | ContactDetail
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
124. Measure.reviewer
Definition | An individual or organization primarily responsible for review of some aspect of the content.
Short | Who reviewed the content
Control | 0..*
Type | ContactDetail
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
126. Measure.endorser
Definition | An individual or organization responsible for officially endorsing the content for use in some setting.
Short | Who endorsed the content
Control | 0..*
Type | ContactDetail
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
128. Measure.relatedArtifact
Definition | Related artifacts such as additional documentation, justification, or bibliographic references.
Short | Additional documentation, citations, etc.
Comments | Each related artifact is either an attachment, or a reference to another resource, but not both.
Control | 0..*
Type | RelatedArtifact
Is Modifier | false
Must Support | true
Summary | false
Requirements | A published measure should provide related information such as supporting evidence, citations, and documentation. Measures must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Measure.relatedArtifact`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ type
130. Measure.relatedArtifact.type
Definition | The type of relationship to the related artifact.
Short | documentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Control | 1..1
Binding | The codes SHALL be taken from RelatedArtifactType http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1 (required to `http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1` ) The type of relationship to the related artifact.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
132. Measure.relatedArtifact.display
Definition | A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.
Short | Brief description of the related artifact
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
134. Measure.relatedArtifact.document
Definition | The document being referenced, represented as an attachment. This is exclusive with the resource element.
Short | What document is being referenced
Control | 0..1
Type | Attachment
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
136. Measure.relatedArtifact.resource
Definition | The related resource, such as a library, value set, profile, or other knowledge resource.
Short | What resource is being referenced
Comments | If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.
Control | 0..1
Type | canonical(Resource, Resource)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
138. Measure.relatedArtifact:predecessor
Slice Name | predecessor
Definition | Reference to a predecessor measure that this measure is replacing. Related artifacts such as additional documentation, justification, or bibliographic references.
Short | Previous measure?Additional documentation, citations, etc.
Comments | Each related artifact is either an attachment, or a reference to another resource, but not both.
Control | 0..1*
Type | RelatedArtifact
Is Modifier | false
Must Support | true
Summary | false
Requirements | A published measure should indicate which measure it is replacing, if any. Measures must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
140. Measure.relatedArtifact:predecessor.type
Definition | The type of relationship to the related artifact.
Short | documentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Control | 1..1
Binding | The codes SHALL be taken from RelatedArtifactType http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1 (required to `http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1` ) The type of relationship to the related artifact.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Fixed Value | `predecessor`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
142. Measure.relatedArtifact:predecessor.display
Definition | A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.
Short | Brief description of the related artifact
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
144. Measure.relatedArtifact:predecessor.document
Definition | The document being referenced, represented as an attachment. This is exclusive with the resource element.
Short | What document is being referenced
Control | 0..1
Type | Attachment
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
146. Measure.relatedArtifact:predecessor.resource
Definition | The related resource, such as a library, value set, profile, or other knowledge resource.
Short | What resource is being referenced
Comments | If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.
Control | 10..1
Type | canonical(Measure, Resource)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
148. Measure.relatedArtifact:citation
Slice Name | citation
Definition | Related artifacts such as additional documentation, justification, or bibliographic references.
Short | Reference/citationAdditional documentation, citations, etc.
Comments | Each related artifact is either an attachment, or a reference to another resource, but not both.
Control | 0..*
Type | RelatedArtifact
Is Modifier | false
Must Support | true
Summary | false
Requirements | Measures must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
150. Measure.relatedArtifact:citation.extension:isPrimaryCitation
Slice Name | isPrimaryCitation
Definition | Specifies whether the related artifact is defining a primary citation for the artifact (i.e. one that should appear in the narrative for the artifact specification.
Short | Primary reference
Control | 0..1
Type | Extension(Is Primary Citation) (Extension Type: boolean)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
152. Measure.relatedArtifact:citation.extension:publicationStatus
Slice Name | publicationStatus
Definition | Specifies the publication status of the referenced artifacts.
Short | Publication status of referenced artifact
Control | 0..1
Type | Extension(Publication Status) (Extension Type: code)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
154. Measure.relatedArtifact:citation.extension:publicationDate
Slice Name | publicationDate
Definition | Specifies the publication date of the referenced artifacts.
Short | Publication date of referenced artifact
Control | 0..1
Type | Extension(CQF Publication Date) (Extension Type: date)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
156. Measure.relatedArtifact:citation.type
Definition | The type of relationship to the related artifact.
Short | documentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Control | 1..1
Binding | The codes SHALL be taken from RelatedArtifactType http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1 (required to `http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1` ) The type of relationship to the related artifact.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Fixed Value | `citation`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
158. Measure.relatedArtifact:citation.display
Definition | A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.
Short | Brief description of the related artifact
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
160. Measure.relatedArtifact:citation.document
Definition | The document being referenced, represented as an attachment. This is exclusive with the resource element.
Short | What document is being referenced
Control | 0..1
Type | Attachment
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
162. Measure.relatedArtifact:citation.resource
Definition | The related resource, such as a library, value set, profile, or other knowledge resource.
Short | What resource is being referenced
Comments | If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.
Control | 0..1
Type | canonical(Resource, Resource)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
164. Measure.relatedArtifact:derived-from
Slice Name | derived-from
Definition | Related artifacts such as additional documentation, justification, or bibliographic references.
Short | URL or canonical reference to other resources that a measure is derived fromAdditional documentation, citations, etc.
Comments | Each related artifact is either an attachment, or a reference to another resource, but not both.
Control | 0..*
Type | RelatedArtifact
Is Modifier | false
Must Support | true
Summary | false
Requirements | Measures must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
166. Measure.relatedArtifact:derived-from.type
Definition | The type of relationship to the related artifact.
Short | documentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Control | 1..1
Binding | The codes SHALL be taken from RelatedArtifactType http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1 (required to `http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1` ) The type of relationship to the related artifact.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Fixed Value | `derived-from`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
168. Measure.relatedArtifact:derived-from.label
Definition | A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.
Short | Short label
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
170. Measure.relatedArtifact:derived-from.display
Definition | A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.
Short | Brief description of the related artifact
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
172. Measure.relatedArtifact:derived-from.url
Definition | A url for the artifact that can be followed to access the actual content.
Short | Should be permalink otherwise include an "accessed date"Where the artifact can be accessed
Comments | If a document or resource element is present, this element SHALL NOT be provided (use the url or reference in the Attachment or resource reference).
Control | 0..1
Type | url
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
174. Measure.relatedArtifact:derived-from.document
Definition | The document being referenced, represented as an attachment. This is exclusive with the resource element.
Short | What document is being referenced
Control | 0..1
Type | Attachment
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
176. Measure.relatedArtifact:derived-from.resource
Definition | The related resource, such as a library, value set, profile, or other knowledge resource.
Short | Should be permalink otherwise include an "accessed date"What resource is being referenced
Comments | If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.
Control | 0..1
Type | canonical(Measure, Resource)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
178. Measure.disclaimer
Definition | Notices and disclaimers regarding the use of the measure or related to intellectual property (such as code systems) referenced by the measure.
Short | Disclaimer for use of the measure or its referenced content
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | A published measure should provide legal disclaimer relating to the use of the measure content. Some organizations require that notices and disclosures be included when publishing measures that reference their intellecutal property.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
180. Measure.type
Definition | Indicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilization.
Short | process | outcome | structure | patient-reported-outcome | composite
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from MeasureType http://hl7.org/fhir/ValueSet/measure-type|4.0.1 (extensible to `http://terminology.hl7.org/ValueSet/measure-type` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | A measure must indicate the type of the measure.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
182. Measure.rationale
Definition | Provides a detailed justification of the need for the measure, including statements pertaining to importance criterion: impact, gap in care, and evidence. Provides a succinct statement of the need for the measure. Usually includes statements pertaining to importance criterion: impact, gap in care, and evidence.
Short | Justification for the measure in terms of impact, gap in care, and evidence.Detailed description of why the measure exists
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Measure developers need to be able to provide a detailed description of the purpose of the measure. This element provides detailed rationale, where the purpose element provides a summary of the rationale.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
184. Measure.definition
Definition | Provides a description of an individual term used within the measure.
Short | Defined terms used in the measure documentation
Control | 0..*
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | Measure developers must be able to provide precise definitions of terms used within measure descriptions and guidance to help communicate the intent of the measure.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
186. Measure.definition.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Measure.definition.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
188. Measure.definition.extension:definitionTerm
Slice Name | definitionTerm
Definition | Specifies a term and its associated definition.
Short | Defined term
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Definition Term) (Complex Extension)
Is Modifier | false
Must Support | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
190. Measure.guidance
Definition | Additional guidance for the measure including how it can be used in a clinical context, and the intent of the measure.
Short | Additional guidance for implementers
Control | 0..01
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | Measure developers must be able to provide additional guidance for implementers to understand the intent with greater specificity than that provided in the population criteria of the measure. This element provides detailed guidance, where the usage element provides a summary of the guidance.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
192. Measure.group
Definition | A group of population criteria for the measure.
Short | Population criteria group
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
194. Measure.group.extension:improvementNotationGuidance
Slice Name | improvementNotationGuidance
Definition | Additional guidance on how to interpret the improvement notation of the measure.
Short | Explanation of improvement notation
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQF Improvement Notation Guidance) (Extension Type: markdown)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
196. Measure.group.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
198. Measure.supplementalData
Definition | The supplemental data criteria for the measure report, specified as either the name of a valid CQL expression within a referenced library, or a valid FHIR Resource Path.
Short | What other data should be reported with the measure
Comments | Note that supplemental data are reported as observations for each patient and included in the evaluatedResources bundle. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
200. Measure.supplementalData.extension:includeInReportType
Slice Name | includeInReportType
Definition | Indicates what types of report the element on which it appears should be included in. If no values are specified, the default behavior is that elements are included in all report types.
Short | The type of report the element should be included in
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(CQM Include In Report Type) (Extension Type: code)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
202. Measure.supplementalData.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
204. Measure.supplementalData.criteria
Definition | The criteria for the supplemental data. This is typically the name of a valid expression defined within a referenced library, but it may also be a path to a specific data element. The criteria defines the data to be returned for this element.
Short | Expression describing additional data to be reported
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

0. Measure
Must Support | false
2. Measure.text
Control | 1..1
Must Support | true
Requirements | A published measure must provide human-readable narrative description of the measure contents.
4. Measure.extension:renderMissingElements
Slice Name | renderMissingElements
Type | Extension(CQM Render Missing Elements) (Extension Type: boolean)
Must Support | false
6. Measure.extension:limitations
Slice Name | limitations
Definition | identifies what limitations should be noted, including potential selection biases and confounding factors when interpreting indicator results or comparing results across the country.
Type | Extension(CQM Limitations) (Extension Type: markdown)
Must Support | false
8. Measure.extension:trendingIssues
Slice Name | trendingIssues
Definition | identifies what issues might affect the interpretation of trending results, including changes in geographic coverage, data quality, coding standards and classification changes (for example, a new ICD standard).
Type | Extension(CQM Trending Issues) (Extension Type: markdown)
Must Support | false
10. Measure.extension:supplementalDataGuidance
Slice Name | supplementalDataGuidance
Control | 0..*
Type | Extension(CQM Supplemental Data Guidance) (Complex Extension)
Must Support | true
12. Measure.extension:comment
Slice Name | comment
Definition | A comment containing additional documentation, a review comment, usage guidance, or other relevant information from a particular user.
Short | Additional documentation, review, or usage guidance
Control | 0..*
Type | Extension(Artifact Comment) (Complex Extension)
Is Modifier | false
Must Support | true
14. Measure.extension:softwaresystem
Slice Name | softwaresystem
Definition | Specifies the software systems used in the packaging and testing of measure and library resources. Specifically to know which version of what software was used.
Short | Extension
Control | 0..*
Type | Extension(CRMI Software System) (Extension Type: Reference(CRMI Software System Device))
Is Modifier | false
Must Support | true
16. Measure.extension:improvementNotationGuidance
Slice Name | improvementNotationGuidance
Control | 0..1
Type | Extension(CQF Improvement Notation Guidance) (Extension Type: markdown)
Must Support | true
18. Measure.identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 3..*
Type | Identifier
Must Support | true
Requirements | A published measure must be able to specify additional identifiers such as endorser and publisher identifiers for the measure.
Slicing | This element introduces a set of slices on `Measure.identifier`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ type
20. Measure.identifier:versionIndependentIdentifier
Slice Name | versionIndependentIdentifier
Definition | The version-independent globally unique identifier for the measure (GUID).
Short | Measure guid
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..1
Must Support | true
22. Measure.identifier:versionIndependentIdentifier.use
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Fixed Value | `official`
24. Measure.identifier:versionIndependentIdentifier.type
Control | 1..1
Type | CodeableConcept
Must Support | true
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "version-independent" }] }`
26. Measure.identifier:versionIndependentIdentifier.system
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Fixed Value | `urn:ietf:rfc:3986`
28. Measure.identifier:versionIndependentIdentifier.value
Control | 1..1
Must Support | true
30. Measure.identifier:versionSpecificIdentifier
Slice Name | versionSpecificIdentifier
Definition | The version-specific globally unique identifier for the measure (GUID).
Short | Measure version guid
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..1
Must Support | true
32. Measure.identifier:versionSpecificIdentifier.use
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Fixed Value | `official`
34. Measure.identifier:versionSpecificIdentifier.type
Control | 1..1
Type | CodeableConcept
Must Support | true
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "version-specific" }] }`
36. Measure.identifier:versionSpecificIdentifier.system
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Fixed Value | `urn:ietf:rfc:3986`
38. Measure.identifier:versionSpecificIdentifier.value
Control | 1..1
Must Support | true
40. Measure.identifier:shortName
Slice Name | shortName
Definition | The short name for the measure (e.g. CMS104v4).
Short | Short name
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..1
Must Support | true
42. Measure.identifier:shortName.use
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Fixed Value | `usual`
44. Measure.identifier:shortName.type
Control | 1..1
Type | CodeableConcept
Must Support | true
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "short-name" }] }`
46. Measure.identifier:shortName.value
Control | 1..1
Must Support | true
48. Measure.identifier:endorserIdentifier
Slice Name | endorserIdentifier
Definition | An identifier assigned by the measure endorser.
Short | Endorser identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Must Support | true
50. Measure.identifier:endorserIdentifier.use
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Fixed Value | `official`
52. Measure.identifier:endorserIdentifier.type
Control | 1..1
Type | CodeableConcept
Must Support | true
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "endorser" }] }`
54. Measure.identifier:endorserIdentifier.system
Control | 0..1
Must Support | true
56. Measure.identifier:endorserIdentifier.value
Control | 1..1
Must Support | true
58. Measure.identifier:endorserIdentifier.assigner
Control | 1..1
Must Support | true
60. Measure.identifier:endorserIdentifier.assigner.display
Control | 1..1
Must Support | true
62. Measure.identifier:publisherIdentifier
Slice Name | publisherIdentifier
Definition | An identifier assigned by the measure publisher.
Short | Publisher identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Must Support | true
64. Measure.identifier:publisherIdentifier.use
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Fixed Value | `official`
66. Measure.identifier:publisherIdentifier.type
Control | 1..1
Type | CodeableConcept
Must Support | true
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "publisher" }] }`
68. Measure.identifier:publisherIdentifier.system
Control | 0..1
Must Support | true
70. Measure.identifier:publisherIdentifier.value
Control | 1..1
Must Support | true
72. Measure.identifier:publisherIdentifier.assigner
Control | 1..1
Must Support | true
74. Measure.identifier:publisherIdentifier.assigner.display
Control | 1..1
Must Support | true
76. Measure.title
Control | 1..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Requirements | A published measure must specify a human-friendly title.
78. Measure.status
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Requirements | A published measure must have a status of active.
80. Measure.date
Control | 1..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Requirements | A published measure must specify the date the measure content was last changed.
82. Measure.publisher
Control | 1..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Requirements | A published measure must provide publisher information.
84. Measure.contact
Control | 1..*
Type | ContactDetail
Must Support | true
Requirements | A published measure must provide contact information for the publisher.
86. Measure.useContext
Control | 0..*
Type | UsageContext
Must Support | true
Requirements | A published measure must be able to specify intended contexts of use such as intended venue.
Slicing | This element introduces a set of slices on `Measure.useContext`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ code
88. Measure.useContext:intendedVenue
Slice Name | intendedVenue
Definition | The intended venue for use for this measure.
Short | What venue?
Control | 0..*
Must Support | true
90. Measure.useContext:intendedVenue.code
Control | 1..1
Type | Coding
Must Support | true
Pattern Value | `{ "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type", "code" : "venue" }`
92. Measure.useContext:intendedVenue.value[x]
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from Intended Venue (extensible to `http://hl7.org/fhir/uv/cqm/ValueSet/intended-venue` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
94. Measure.purpose
Definition | Explanation of why this measure is needed and why it has been designed as it has.
Short | Why this measure is defined
Control | 0..1
Must Support | true
Requirements | A published measure should provide a clear description of the purpose of the measure.
96. Measure.usage
Short | Allows measure developers to provide additional guidance so that implementers can more easily interpret and implement components of the measure.
Must Support | true
Requirements | A published measure should provide clinical usage notes for the measure.
98. Measure.copyright
Must Support | true
Requirements | A published measure should provide copyright information for the measure content.
100. Measure.approvalDate
Must Support | true
Requirements | A published measure must indicate the date the measure content was approved by the publisher.
102. Measure.lastReviewDate
Must Support | true
Requirements | A published measure must indicate when the measure content was last reviewed.
104. Measure.effectivePeriod
Must Support | true
Requirements | A published measure should provide an indication of the period during which the measure content can be effectively applied.
106. Measure.effectivePeriod.extension:anchor
Slice Name | anchor
Control | 0..1
Type | Extension(CQM Effective Period Anchor) (Extension Type: dateTime)
Must Support | true
108. Measure.effectivePeriod.extension:duration
Slice Name | duration
Control | 0..1
Type | Extension(CQM Effective Period Duration) (Extension Type: Duration)
Must Support | true
110. Measure.topic
Must Support | true
Requirements | A published measure should provide relevant topics for the measure content.
112. Measure.author
Must Support | true
114. Measure.editor
Must Support | true
116. Measure.reviewer
Must Support | true
118. Measure.endorser
Must Support | true
120. Measure.relatedArtifact
Must Support | true
Requirements | A published measure should provide related information such as supporting evidence, citations, and documentation.
Slicing | This element introduces a set of slices on `Measure.relatedArtifact`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ type
122. Measure.relatedArtifact:predecessor
Slice Name | predecessor
Definition | Reference to a predecessor measure that this measure is replacing.
Short | Previous measure?
Control | 0..1
Must Support | true
Requirements | A published measure should indicate which measure it is replacing, if any.
124. Measure.relatedArtifact:predecessor.type
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Fixed Value | `predecessor`
126. Measure.relatedArtifact:predecessor.resource
Control | 1..1
Type | canonical(Measure)
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
128. Measure.relatedArtifact:citation
Slice Name | citation
Short | Reference/citation
Control | 0..*
Must Support | true
130. Measure.relatedArtifact:citation.extension:isPrimaryCitation
Slice Name | isPrimaryCitation
Control | 0..1
Type | Extension(Is Primary Citation) (Extension Type: boolean)
Must Support | false
132. Measure.relatedArtifact:citation.extension:publicationStatus
Slice Name | publicationStatus
Control | 0..1
Type | Extension(Publication Status) (Extension Type: code)
Must Support | false
134. Measure.relatedArtifact:citation.extension:publicationDate
Slice Name | publicationDate
Control | 0..1
Type | Extension(CQF Publication Date) (Extension Type: date)
Must Support | false
136. Measure.relatedArtifact:citation.type
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Fixed Value | `citation`
138. Measure.relatedArtifact:derived-from
Slice Name | derived-from
Short | URL or canonical reference to other resources that a measure is derived from
Control | 0..*
Must Support | true
140. Measure.relatedArtifact:derived-from.type
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Fixed Value | `derived-from`
142. Measure.relatedArtifact:derived-from.label
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
144. Measure.relatedArtifact:derived-from.display
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
146. Measure.relatedArtifact:derived-from.url
Short | Should be permalink otherwise include an "accessed date"
Control | 0..1
Type | url
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
148. Measure.relatedArtifact:derived-from.resource
Short | Should be permalink otherwise include an "accessed date"
Control | 0..1
Type | canonical(Measure)
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
150. Measure.disclaimer
Must Support | true
Requirements | A published measure should provide legal disclaimer relating to the use of the measure content.
152. Measure.type
Definition | Indicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilization.
Short | process | outcome | structure | patient-reported-outcome | composite
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from MeasureType (extensible to `http://terminology.hl7.org/ValueSet/measure-type` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Requirements | A measure must indicate the type of the measure.
154. Measure.rationale
Definition | Provides a detailed justification of the need for the measure, including statements pertaining to importance criterion: impact, gap in care, and evidence.
Short | Justification for the measure in terms of impact, gap in care, and evidence.
Control | 0..1
Must Support | true
156. Measure.definition
Control | 0..*
Must Support | false
158. Measure.definition.extension:definitionTerm
Slice Name | definitionTerm
Control | 1..1
Type | Extension(Definition Term) (Complex Extension)
Must Support | false
160. Measure.guidance
Control | 0..0
Must Support | false
162. Measure.group
164. Measure.group.extension:improvementNotationGuidance
Slice Name | improvementNotationGuidance
Control | 0..1
Type | Extension(CQF Improvement Notation Guidance) (Extension Type: markdown)
Must Support | true
166. Measure.supplementalData
Must Support | true
168. Measure.supplementalData.extension:includeInReportType
Slice Name | includeInReportType
Control | 0..*
Type | Extension(CQM Include In Report Type) (Extension Type: code)
Must Support | true

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

0. Measure
Definition | The Measure resource provides the definition of a quality measure.
Short | A quality measure definition
Control | 1..1
Is Modifier | false
Must Support | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (`contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (`contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`) mea-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (`name.matches('[A-Z]([A-Za-z0-9_]){0,254}')`) mea-1: Stratifier SHALL be either a single criteria or a set of criteria components (`group.stratifier.all((code | description | criteria).exists() xor component.exists())`)
2. Measure.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. Measure.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. Measure.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. Measure.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. Measure.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 1..1
Type | Narrative
Is Modifier | false
Must Support | true
Summary | false
Requirements | A published measure must provide human-readable narrative description of the measure contents.
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. Measure.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. Measure.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. Measure.extension:copyrightLabel
Slice Name | copyrightLabel
Definition | A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. (e.g. 'All rights reserved', 'Some rights reserved').
Short | Copyright holder and year(s)
Comments | Defines the content expected to be rendered in all representations of the artifact. The (c) symbol should NOT be included in this string. It is expected to be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.
Control | 0..1
Type | Extension(Artifact Copyright Label) (Extension Type: string)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. Measure.extension:renderMissingElements
Slice Name | renderMissingElements
Definition | Indicates whether to render missing elements (including population criteria, stratifiers, and supplemental data elements) in measure narrative. True indicates that missing elements should be rendered with an appropriate indicator (such as None, or N/A) when elements that would be expected to be present are not specified in a measure. For example, the denominator exclusion criteria for a proportion measure will be rendered as None if it is not present in a proportion measure.
Short | Render missing elements?
Comments | If this extension is not present, measure narrative will render as though it is false (i.e. missing elements will not render in the measure narrative)
Control | 0..1
Type | Extension(CQM Render Missing Elements) (Extension Type: boolean)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
20. Measure.extension:limitations
Slice Name | limitations
Definition | identifies what limitations should be noted, including potential selection biases and confounding factors when interpreting indicator results or comparing results across the country.
Short | Extension
Control | 0..1
Type | Extension(CQM Limitations) (Extension Type: markdown)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
22. Measure.extension:trendingIssues
Slice Name | trendingIssues
Definition | identifies what issues might affect the interpretation of trending results, including changes in geographic coverage, data quality, coding standards and classification changes (for example, a new ICD standard).
Short | Extension
Control | 0..1
Type | Extension(CQM Trending Issues) (Extension Type: markdown)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
24. Measure.extension:supplementalDataGuidance
Slice Name | supplementalDataGuidance
Definition | Specifies additional guidance related to the collection and reporting of supplemental data elements defined in the measure.
Short | Supplemental data guidance
Control | 0..*
Type | Extension(CQM Supplemental Data Guidance) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
26. Measure.extension:comment
Slice Name | comment
Definition | A comment containing additional documentation, a review comment, usage guidance, or other relevant information from a particular user.
Short | Additional documentation, review, or usage guidance
Control | 0..*
Type | Extension(Artifact Comment) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
28. Measure.extension:softwaresystem
Slice Name | softwaresystem
Definition | Specifies the software systems used in the packaging and testing of measure and library resources. Specifically to know which version of what software was used.
Short | Extension
Control | 0..*
Type | Extension(CRMI Software System) (Extension Type: Reference(CRMI Software System Device))
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
30. Measure.extension:improvementNotationGuidance
Slice Name | improvementNotationGuidance
Definition | Additional guidance on how to interpret the improvement notation of the measure.
Short | Explanation of improvement notation
Control | 0..1
Type | Extension(CQF Improvement Notation Guidance) (Extension Type: markdown)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
32. Measure.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
34. Measure.url
Definition | An absolute URI that is used to identify this measure when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this measure is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the measure is stored on different servers.
Short | Canonical identifier for this measure, represented as a URI (globally unique)
Comments | Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version. The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions. In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the measure to be referenced by a single globally unique identifier.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. Measure.identifier
Definition | A formal identifier that is used to identify this measure when it is represented in other formats, or referenced in a specification, model, design or an instance.
Short | Additional identifier for the measure
Comments | Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this measure outside of FHIR, where it is not possible to use the logical URI.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 3..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | A published measure must be able to specify additional identifiers such as endorser and publisher identifiers for the measure.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Measure.identifier`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ type
38. Measure.identifier:versionIndependentIdentifier
Slice Name | versionIndependentIdentifier
Definition | The version-independent globally unique identifier for the measure (GUID).
Short | Measure guid
Comments | Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this measure outside of FHIR, where it is not possible to use the logical URI.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..1
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows externally provided and/or usable business identifiers to be easily associated with the module.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. Measure.identifier:versionIndependentIdentifier.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
42. Measure.identifier:versionIndependentIdentifier.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.identifier.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
44. Measure.identifier:versionIndependentIdentifier.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 1..1
Binding | The codes SHALL be taken from IdentifierUse (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Fixed Value | `official`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. Measure.identifier:versionIndependentIdentifier.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to `http://hl7.org/fhir/ValueSet/identifier-type|4.0.1` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "version-independent" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. Measure.identifier:versionIndependentIdentifier.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Fixed Value | `urn:ietf:rfc:3986`
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. Measure.identifier:versionIndependentIdentifier.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. Measure.identifier:versionIndependentIdentifier.period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. Measure.identifier:versionIndependentIdentifier.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. Measure.identifier:versionSpecificIdentifier
Slice Name | versionSpecificIdentifier
Definition | The version-specific globally unique identifier for the measure (GUID).
Short | Measure version guid
Comments | Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this measure outside of FHIR, where it is not possible to use the logical URI.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..1
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows externally provided and/or usable business identifiers to be easily associated with the module.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. Measure.identifier:versionSpecificIdentifier.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
60. Measure.identifier:versionSpecificIdentifier.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.identifier.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
62. Measure.identifier:versionSpecificIdentifier.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 1..1
Binding | The codes SHALL be taken from IdentifierUse (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Fixed Value | `official`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
64. Measure.identifier:versionSpecificIdentifier.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to `http://hl7.org/fhir/ValueSet/identifier-type|4.0.1` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "version-specific" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. Measure.identifier:versionSpecificIdentifier.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Fixed Value | `urn:ietf:rfc:3986`
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. Measure.identifier:versionSpecificIdentifier.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. Measure.identifier:versionSpecificIdentifier.period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. Measure.identifier:versionSpecificIdentifier.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. Measure.identifier:shortName
Slice Name | shortName
Definition | The short name for the measure (e.g. CMS104v4).
Short | Short name
Comments | Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this measure outside of FHIR, where it is not possible to use the logical URI.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..1
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows externally provided and/or usable business identifiers to be easily associated with the module.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. Measure.identifier:shortName.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
78. Measure.identifier:shortName.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.identifier.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
80. Measure.identifier:shortName.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 1..1
Binding | The codes SHALL be taken from IdentifierUse (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Fixed Value | `usual`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. Measure.identifier:shortName.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to `http://hl7.org/fhir/ValueSet/identifier-type|4.0.1` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "short-name" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. Measure.identifier:shortName.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. Measure.identifier:shortName.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
88. Measure.identifier:shortName.period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
90. Measure.identifier:shortName.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
92. Measure.identifier:endorserIdentifier
Slice Name | endorserIdentifier
Definition | An identifier assigned by the measure endorser.
Short | Endorser identifier
Comments | Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this measure outside of FHIR, where it is not possible to use the logical URI.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows externally provided and/or usable business identifiers to be easily associated with the module.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
94. Measure.identifier:endorserIdentifier.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
96. Measure.identifier:endorserIdentifier.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.identifier.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
98. Measure.identifier:endorserIdentifier.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 1..1
Binding | The codes SHALL be taken from IdentifierUse (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Fixed Value | `official`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. Measure.identifier:endorserIdentifier.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to `http://hl7.org/fhir/ValueSet/identifier-type|4.0.1` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "endorser" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
102. Measure.identifier:endorserIdentifier.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
104. Measure.identifier:endorserIdentifier.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
106. Measure.identifier:endorserIdentifier.period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
108. Measure.identifier:endorserIdentifier.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 1..1
Type | Reference(Organization)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
110. Measure.identifier:endorserIdentifier.assigner.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
112. Measure.identifier:endorserIdentifier.assigner.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.identifier.assigner.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
114. Measure.identifier:endorserIdentifier.assigner.reference
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Short | Literal reference, Relative, internal or absolute URL
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Control | 0..1 This element is affected by the following invariants: ref-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
116. Measure.identifier:endorserIdentifier.assigner.type
Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Short | Type the reference refers to (e.g. "Patient")
Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` ) Aa resource (or, for logical models, the URI of the logical model).
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
118. Measure.identifier:endorserIdentifier.assigner.identifier
Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Short | Logical reference, when literal reference is not known
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
120. Measure.identifier:endorserIdentifier.assigner.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Short | Text alternative for the resource
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
122. Measure.identifier:publisherIdentifier
Slice Name | publisherIdentifier
Definition | An identifier assigned by the measure publisher.
Short | Publisher identifier
Comments | Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this measure outside of FHIR, where it is not possible to use the logical URI.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows externally provided and/or usable business identifiers to be easily associated with the module.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
124. Measure.identifier:publisherIdentifier.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
126. Measure.identifier:publisherIdentifier.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.identifier.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
128. Measure.identifier:publisherIdentifier.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 1..1
Binding | The codes SHALL be taken from IdentifierUse (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Fixed Value | `official`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
130. Measure.identifier:publisherIdentifier.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to `http://hl7.org/fhir/ValueSet/identifier-type|4.0.1` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type", "code" : "publisher" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
132. Measure.identifier:publisherIdentifier.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
134. Measure.identifier:publisherIdentifier.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
136. Measure.identifier:publisherIdentifier.period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
138. Measure.identifier:publisherIdentifier.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 1..1
Type | Reference(Organization)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
140. Measure.identifier:publisherIdentifier.assigner.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
142. Measure.identifier:publisherIdentifier.assigner.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.identifier.assigner.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
144. Measure.identifier:publisherIdentifier.assigner.reference
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Short | Literal reference, Relative, internal or absolute URL
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Control | 0..1 This element is affected by the following invariants: ref-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
146. Measure.identifier:publisherIdentifier.assigner.type
Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Short | Type the reference refers to (e.g. "Patient")
Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` ) Aa resource (or, for logical models, the URI of the logical model).
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
148. Measure.identifier:publisherIdentifier.assigner.identifier
Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Short | Logical reference, when literal reference is not known
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
150. Measure.identifier:publisherIdentifier.assigner.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Short | Text alternative for the resource
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
152. Measure.version
Definition | The identifier that is used to identify this version of the measure when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the measure author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifacts.
Short | Business version of the measure
Comments | There may be different measure instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the measure with the format [url]|[version].
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
154. Measure.name
Definition | A natural language name identifying the measure. This name should be usable as an identifier for the module by machine processing applications such as code generation.
Short | Name for this measure (computer friendly)
Comments | The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.
Control | 0..1 This element is affected by the following invariants: inv-0
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Support human navigation and code generation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
156. Measure.title
Definition | A short, descriptive, user-friendly title for the measure.
Short | Name for this measure (human friendly)
Comments | This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | A published measure must specify a human-friendly title.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
158. Measure.subtitle
Definition | An explanatory or alternate title for the measure giving additional information about its content.
Short | Subordinate title of the measure
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
160. Measure.status
Definition | The status of this measure. Enables tracking the life-cycle of the content.
Short | draft | active | retired | unknown
Comments | Allows filtering of measures that are appropriate for use versus not.
Control | 1..1
Binding | The codes SHALL be taken from PublicationStatus (required to `http://hl7.org/fhir/ValueSet/publication-status|4.0.1` ) The lifecycle status of an artifact.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | A published measure must have a status of active.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
162. Measure.experimental
Definition | A Boolean value to indicate that this measure is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.
Short | For testing purposes, not real usage
Comments | Allows filtering of measures that are appropriate for use versus not.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Enables experimental content to be developed following the same lifecycle that would be used for a production-level measure.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
164. Measure.subject[x]
Definition | The intended subjects for the measure. If this element is not provided, a Patient subject is assumed, but the subject of the measure can be anything.
Short | E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
Comments | The subject of the measure is critical in interpreting the criteria definitions, as the logic in the measures is evaluated with respect to a particular subject. This corresponds roughly to the notion of a Compartment in that it limits what content is available based on its relationship to the subject. In CQL, this corresponds to the context declaration.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from SubjectType (extensible to `http://hl7.org/fhir/ValueSet/subject-type` ) The possible types of subjects for a measure (E.g. Patient, Practitioner, Organization, Location, etc.).
Type | Choice of: CodeableConcept, Reference(Group)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Meaning if Missing | Patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
166. Measure.date
Definition | The date (and optionally time) when the measure was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the measure changes.
Short | Date last changed
Comments | Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the measure. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.
Control | 1..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | A published measure must specify the date the measure content was last changed.
Alternate Names | Revision Date
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
168. Measure.publisher
Definition | The name of the organization or individual that published the measure.
Short | Name of the publisher (organization or individual)
Comments | Usually an organization but may be an individual. The publisher (or steward) of the measure is the organization or individual primarily responsible for the maintenance and upkeep of the measure. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the measure. This item SHOULD be populated unless the information is available from context.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | A published measure must provide publisher information.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
170. Measure.contact
Definition | Contact details to assist a user in finding and communicating with the publisher.
Short | Contact details for the publisher
Comments | May be a web site, an email address, a telephone number, etc.
Control | 1..*
Type | ContactDetail
Is Modifier | false
Must Support | true
Summary | true
Requirements | A published measure must provide contact information for the publisher.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
172. Measure.description
Definition | A free text natural language description of the measure from a consumer's perspective.
Short | Natural language description of the measure
Comments | This description can be used to capture details such as why the measure was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the measure as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the measure is presumed to be the predominant language in the place the measure was created).
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
174. Measure.useContext
Definition | The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate measure instances.
Short | The context that the content is intended to support
Comments | When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.
Control | 0..*
Type | UsageContext
Is Modifier | false
Must Support | true
Summary | true
Requirements | A published measure must be able to specify intended contexts of use such as intended venue.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Measure.useContext`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ code
176. Measure.useContext:intendedVenue
Slice Name | intendedVenue
Definition | The intended venue for use for this measure.
Short | What venue?
Comments | When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.
Control | 0..*
Type | UsageContext
Is Modifier | false
Must Support | true
Summary | true
Requirements | Assist in searching for appropriate content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
178. Measure.useContext:intendedVenue.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
180. Measure.useContext:intendedVenue.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.useContext.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
182. Measure.useContext:intendedVenue.code
Definition | A code that identifies the type of context being specified by this usage context.
Short | Type of context being specified
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from UsageContextType (extensible to `http://hl7.org/fhir/ValueSet/usage-context-type|4.0.1` ) A code that specifies a type of context being specified by a usage context.
Type | Coding
Is Modifier | false
Must Support | true
Summary | true
Pattern Value | `{ "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type", "code" : "venue" }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
184. Measure.useContext:intendedVenue.value[x]
Definition | A value that defines the context specified in this context of use. The interpretation of the value is defined by the code.
Short | Value that defines the context
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from Intended Venue (extensible to `http://hl7.org/fhir/uv/cqm/ValueSet/intended-venue` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
186. Measure.jurisdiction
Definition | A legal or geographic region in which the measure is intended to be used.
Short | Intended jurisdiction for measure (if applicable)
Comments | It may be possible for the measure to be used in jurisdictions other than those for which it was originally designed or intended.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from Jurisdiction ValueSet (extensible to `http://hl7.org/fhir/ValueSet/jurisdiction` ) Countries and regions within which this artifact is targeted for use.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
188. Measure.purpose
Definition | Explanation of why this measure is needed and why it has been designed as it has.
Short | Why this measure is defined
Comments | This element does not describe the usage of the measure. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this measure.
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | A published measure should provide a clear description of the purpose of the measure.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
190. Measure.usage
Definition | A detailed description, from a clinical perspective, of how the measure is used.
Short | Allows measure developers to provide additional guidance so that implementers can more easily interpret and implement components of the measure.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | A published measure should provide clinical usage notes for the measure.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
192. Measure.copyright
Definition | A copyright statement relating to the measure and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the measure.
Short | Use and/or publishing restrictions
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | A published measure should provide copyright information for the measure content.
Alternate Names | License, Restrictions
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
194. Measure.approvalDate
Definition | The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.
Short | When the measure was approved by publisher
Comments | The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.
Control | 0..1
Type | date
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | A published measure must indicate the date the measure content was approved by the publisher.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
196. Measure.lastReviewDate
Definition | The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.
Short | When the measure was last reviewed
Comments | If specified, this date follows the original approval date.
Control | 0..1
Type | date
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | A published measure must indicate when the measure content was last reviewed.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
198. Measure.effectivePeriod
Definition | The period during which the measure content was or is planned to be in active use.
Short | When the measure is expected to be used
Comments | The effective period for a measure determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.
Control | 0..1
Type | Period
Is Modifier | false
Must Support | true
Summary | true
Requirements | A published measure should provide an indication of the period during which the measure content can be effectively applied.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
200. Measure.effectivePeriod.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
202. Measure.effectivePeriod.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.effectivePeriod.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
204. Measure.effectivePeriod.extension:anchor
Slice Name | anchor
Definition | Specifies the anchor date for the effective period as defined by a starting date and a range.
Short | Date of first effective use
Control | 0..1
Type | Extension(CQM Effective Period Anchor) (Extension Type: dateTime)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
206. Measure.effectivePeriod.extension:duration
Slice Name | duration
Definition | Specifies the reporting period for the measure.
Short | What reporting period is used
Control | 0..1
Type | Extension(CQM Effective Period Duration) (Extension Type: Duration)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
208. Measure.effectivePeriod.start
Definition | The start of the period. The boundary is inclusive.
Short | Starting time with inclusive boundary
Comments | If the low element is missing, the meaning is that the low boundary is not known.
Control | 0..1 This element is affected by the following invariants: per-1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
210. Measure.effectivePeriod.end
Definition | The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Short | End time with inclusive boundary, if not ongoing
Comments | The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
Control | 0..1 This element is affected by the following invariants: per-1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Meaning if Missing | If the end of the period is missing, it means that the period is ongoing
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
212. Measure.topic
Definition | Descriptive topics related to the content of the measure. Topics provide a high-level categorization grouping types of measures that can be useful for filtering and searching.
Short | The category of the measure, such as Education, Treatment, Assessment, etc.
Control | 0..*
Binding | For example codes, see DefinitionTopic (example to `http://hl7.org/fhir/ValueSet/definition-topic` ) High-level categorization of the definition, used for searching, sorting, and filtering.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Requirements | A published measure should provide relevant topics for the measure content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
214. Measure.author
Definition | An individiual or organization primarily involved in the creation and maintenance of the content.
Short | Who authored the content
Control | 0..*
Type | ContactDetail
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
216. Measure.editor
Definition | An individual or organization primarily responsible for internal coherence of the content.
Short | Who edited the content
Control | 0..*
Type | ContactDetail
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
218. Measure.reviewer
Definition | An individual or organization primarily responsible for review of some aspect of the content.
Short | Who reviewed the content
Control | 0..*
Type | ContactDetail
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
220. Measure.endorser
Definition | An individual or organization responsible for officially endorsing the content for use in some setting.
Short | Who endorsed the content
Control | 0..*
Type | ContactDetail
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
222. Measure.relatedArtifact
Definition | Related artifacts such as additional documentation, justification, or bibliographic references.
Short | Additional documentation, citations, etc.
Comments | Each related artifact is either an attachment, or a reference to another resource, but not both.
Control | 0..*
Type | RelatedArtifact
Is Modifier | false
Must Support | true
Summary | false
Requirements | A published measure should provide related information such as supporting evidence, citations, and documentation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Measure.relatedArtifact`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ type
224. Measure.relatedArtifact.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
226. Measure.relatedArtifact.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.relatedArtifact.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
228. Measure.relatedArtifact.type
Definition | The type of relationship to the related artifact.
Short | documentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Control | 1..1
Binding | The codes SHALL be taken from RelatedArtifactType (required to `http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1` ) The type of relationship to the related artifact.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
230. Measure.relatedArtifact.label
Definition | A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.
Short | Short label
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
232. Measure.relatedArtifact.display
Definition | A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.
Short | Brief description of the related artifact
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
234. Measure.relatedArtifact.citation
Definition | A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format.
Short | Bibliographic citation for the artifact
Comments | Additional structured information about citations should be captured as extensions.
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
236. Measure.relatedArtifact.url
Definition | A url for the artifact that can be followed to access the actual content.
Short | Where the artifact can be accessed
Comments | If a document or resource element is present, this element SHALL NOT be provided (use the url or reference in the Attachment or resource reference).
Control | 0..1
Type | url
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
238. Measure.relatedArtifact.document
Definition | The document being referenced, represented as an attachment. This is exclusive with the resource element.
Short | What document is being referenced
Control | 0..1
Type | Attachment
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
240. Measure.relatedArtifact.resource
Definition | The related resource, such as a library, value set, profile, or other knowledge resource.
Short | What resource is being referenced
Comments | If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.
Control | 0..1
Type | canonical(Resource)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
242. Measure.relatedArtifact:predecessor
Slice Name | predecessor
Definition | Reference to a predecessor measure that this measure is replacing.
Short | Previous measure?
Comments | Each related artifact is either an attachment, or a reference to another resource, but not both.
Control | 0..1
Type | RelatedArtifact
Is Modifier | false
Must Support | true
Summary | false
Requirements | A published measure should indicate which measure it is replacing, if any.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
244. Measure.relatedArtifact:predecessor.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
246. Measure.relatedArtifact:predecessor.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.relatedArtifact.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
248. Measure.relatedArtifact:predecessor.type
Definition | The type of relationship to the related artifact.
Short | documentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Control | 1..1
Binding | The codes SHALL be taken from RelatedArtifactType (required to `http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1` ) The type of relationship to the related artifact.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Fixed Value | `predecessor`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
250. Measure.relatedArtifact:predecessor.label
Definition | A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.
Short | Short label
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
252. Measure.relatedArtifact:predecessor.display
Definition | A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.
Short | Brief description of the related artifact
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
254. Measure.relatedArtifact:predecessor.citation
Definition | A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format.
Short | Bibliographic citation for the artifact
Comments | Additional structured information about citations should be captured as extensions.
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
256. Measure.relatedArtifact:predecessor.url
Definition | A url for the artifact that can be followed to access the actual content.
Short | Where the artifact can be accessed
Comments | If a document or resource element is present, this element SHALL NOT be provided (use the url or reference in the Attachment or resource reference).
Control | 0..1
Type | url
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
258. Measure.relatedArtifact:predecessor.document
Definition | The document being referenced, represented as an attachment. This is exclusive with the resource element.
Short | What document is being referenced
Control | 0..1
Type | Attachment
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
260. Measure.relatedArtifact:predecessor.resource
Definition | The related resource, such as a library, value set, profile, or other knowledge resource.
Short | What resource is being referenced
Comments | If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.
Control | 1..1
Type | canonical(Measure)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
262. Measure.relatedArtifact:citation
Slice Name | citation
Definition | Related artifacts such as additional documentation, justification, or bibliographic references.
Short | Reference/citation
Comments | Each related artifact is either an attachment, or a reference to another resource, but not both.
Control | 0..*
Type | RelatedArtifact
Is Modifier | false
Must Support | true
Summary | false
Requirements | Measures must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
264. Measure.relatedArtifact:citation.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
266. Measure.relatedArtifact:citation.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.relatedArtifact.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
268. Measure.relatedArtifact:citation.extension:isPrimaryCitation
Slice Name | isPrimaryCitation
Definition | Specifies whether the related artifact is defining a primary citation for the artifact (i.e. one that should appear in the narrative for the artifact specification.
Short | Primary reference
Control | 0..1
Type | Extension(Is Primary Citation) (Extension Type: boolean)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
270. Measure.relatedArtifact:citation.extension:publicationStatus
Slice Name | publicationStatus
Definition | Specifies the publication status of the referenced artifacts.
Short | Publication status of referenced artifact
Control | 0..1
Type | Extension(Publication Status) (Extension Type: code)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
272. Measure.relatedArtifact:citation.extension:publicationDate
Slice Name | publicationDate
Definition | Specifies the publication date of the referenced artifacts.
Short | Publication date of referenced artifact
Control | 0..1
Type | Extension(CQF Publication Date) (Extension Type: date)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
274. Measure.relatedArtifact:citation.type
Definition | The type of relationship to the related artifact.
Short | documentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Control | 1..1
Binding | The codes SHALL be taken from RelatedArtifactType (required to `http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1` ) The type of relationship to the related artifact.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Fixed Value | `citation`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
276. Measure.relatedArtifact:citation.label
Definition | A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.
Short | Short label
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
278. Measure.relatedArtifact:citation.display
Definition | A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.
Short | Brief description of the related artifact
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
280. Measure.relatedArtifact:citation.citation
Definition | A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format.
Short | Bibliographic citation for the artifact
Comments | Additional structured information about citations should be captured as extensions.
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
282. Measure.relatedArtifact:citation.url
Definition | A url for the artifact that can be followed to access the actual content.
Short | Where the artifact can be accessed
Comments | If a document or resource element is present, this element SHALL NOT be provided (use the url or reference in the Attachment or resource reference).
Control | 0..1
Type | url
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
284. Measure.relatedArtifact:citation.document
Definition | The document being referenced, represented as an attachment. This is exclusive with the resource element.
Short | What document is being referenced
Control | 0..1
Type | Attachment
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
286. Measure.relatedArtifact:citation.resource
Definition | The related resource, such as a library, value set, profile, or other knowledge resource.
Short | What resource is being referenced
Comments | If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.
Control | 0..1
Type | canonical(Resource)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
288. Measure.relatedArtifact:derived-from
Slice Name | derived-from
Definition | Related artifacts such as additional documentation, justification, or bibliographic references.
Short | URL or canonical reference to other resources that a measure is derived from
Comments | Each related artifact is either an attachment, or a reference to another resource, but not both.
Control | 0..*
Type | RelatedArtifact
Is Modifier | false
Must Support | true
Summary | false
Requirements | Measures must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
290. Measure.relatedArtifact:derived-from.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
292. Measure.relatedArtifact:derived-from.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.relatedArtifact.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
294. Measure.relatedArtifact:derived-from.type
Definition | The type of relationship to the related artifact.
Short | documentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
Control | 1..1
Binding | The codes SHALL be taken from RelatedArtifactType (required to `http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1` ) The type of relationship to the related artifact.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Fixed Value | `derived-from`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
296. Measure.relatedArtifact:derived-from.label
Definition | A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.
Short | Short label
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
298. Measure.relatedArtifact:derived-from.display
Definition | A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.
Short | Brief description of the related artifact
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
300. Measure.relatedArtifact:derived-from.citation
Definition | A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format.
Short | Bibliographic citation for the artifact
Comments | Additional structured information about citations should be captured as extensions.
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
302. Measure.relatedArtifact:derived-from.url
Definition | A url for the artifact that can be followed to access the actual content.
Short | Should be permalink otherwise include an "accessed date"
Comments | If a document or resource element is present, this element SHALL NOT be provided (use the url or reference in the Attachment or resource reference).
Control | 0..1
Type | url
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
304. Measure.relatedArtifact:derived-from.document
Definition | The document being referenced, represented as an attachment. This is exclusive with the resource element.
Short | What document is being referenced
Control | 0..1
Type | Attachment
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
306. Measure.relatedArtifact:derived-from.resource
Definition | The related resource, such as a library, value set, profile, or other knowledge resource.
Short | Should be permalink otherwise include an "accessed date"
Comments | If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.
Control | 0..1
Type | canonical(Measure)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
308. Measure.library
Definition | A reference to a Library resource containing the formal logic used by the measure.
Short | Logic used by the measure
Control | 0..*
Type | canonical(Library)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
310. Measure.disclaimer
Definition | Notices and disclaimers regarding the use of the measure or related to intellectual property (such as code systems) referenced by the measure.
Short | Disclaimer for use of the measure or its referenced content
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | A published measure should provide legal disclaimer relating to the use of the measure content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
312. Measure.scoring
Definition | Indicates how the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort. The value set is extensible, allowing additional measure scoring types to be represented.
Short | proportion | ratio | continuous-variable | cohort
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from MeasureScoring (extensible to `http://hl7.org/fhir/ValueSet/measure-scoring` ) The scoring type of the measure.
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
314. Measure.compositeScoring
Definition | If this is a composite measure, the scoring method used to combine the component measures to determine the composite score.
Short | opportunity | all-or-nothing | linear | weighted
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from CompositeMeasureScoring (extensible to `http://hl7.org/fhir/ValueSet/composite-measure-scoring` ) The composite scoring method of the measure.
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
316. Measure.type
Definition | Indicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilization.
Short | process | outcome | structure | patient-reported-outcome | composite
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from MeasureType (extensible to `http://terminology.hl7.org/ValueSet/measure-type` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | A measure must indicate the type of the measure.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
318. Measure.riskAdjustment
Definition | A description of the risk adjustment factors that may impact the resulting score for the measure and how they may be accounted for when computing and reporting measure results.
Short | How risk adjustment is applied for this measure
Comments | Describes the method of adjusting for clinical severity and conditions present at the start of care that can influence patient outcomes for making valid comparisons of outcome measures across providers. Indicates whether a measure is subject to the statistical process for reducing, removing, or clarifying the influences of confounding factors to allow for more useful comparisons.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
320. Measure.rateAggregation
Definition | Describes how to combine the information calculated, based on logic in each of several populations, into one summarized result.
Short | How is rate aggregation performed for this measure
Comments | The measure rate for an organization or clinician is based upon the entities’ aggregate data and summarizes the performance of the entity over a given time period (e.g., monthly, quarterly, yearly). The aggregated data are derived from the results of a specific measure algorithm and, if appropriate, the application of specific risk adjustment models. Can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure (e.g., pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two). This could be applied to aggregated cohort measure definitions (e.g., CDC's aggregate reporting for TB at the state level).
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
322. Measure.rationale
Definition | Provides a detailed justification of the need for the measure, including statements pertaining to importance criterion: impact, gap in care, and evidence.
Short | Justification for the measure in terms of impact, gap in care, and evidence.
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Measure developers need to be able to provide a detailed description of the purpose of the measure. This element provides detailed rationale, where the purpose element provides a summary of the rationale.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
324. Measure.clinicalRecommendationStatement
Definition | Provides a summary of relevant clinical guidelines or other clinical recommendations supporting the measure.
Short | Summary of clinical guidelines
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
326. Measure.improvementNotation
Definition | Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range).
Short | increase | decrease
Control | 0..1
Binding | The codes SHALL be taken from MeasureImprovementNotation (required to `http://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.1` ) Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Measure consumers and implementers must be able to determine how to interpret a measure score.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
328. Measure.definition
Definition | Provides a description of an individual term used within the measure.
Short | Defined terms used in the measure documentation
Control | 0..*
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | Measure developers must be able to provide precise definitions of terms used within measure descriptions and guidance to help communicate the intent of the measure.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
330. Measure.definition.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
332. Measure.definition.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.definition.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
334. Measure.definition.extension:definitionTerm
Slice Name | definitionTerm
Definition | Specifies a term and its associated definition.
Short | Defined term
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Definition Term) (Complex Extension)
Is Modifier | false
Must Support | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
336. Measure.definition.value
Definition | Primitive value for markdown
Short | Primitive value for markdown
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
338. Measure.guidance
Definition | Additional guidance for the measure including how it can be used in a clinical context, and the intent of the measure.
Short | Additional guidance for implementers
Control | 0..0
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | Measure developers must be able to provide additional guidance for implementers to understand the intent with greater specificity than that provided in the population criteria of the measure. This element provides detailed guidance, where the usage element provides a summary of the guidance.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
340. Measure.group
Definition | A group of population criteria for the measure.
Short | Population criteria group
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
342. Measure.group.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
344. Measure.group.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.group.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
346. Measure.group.extension:improvementNotationGuidance
Slice Name | improvementNotationGuidance
Definition | Additional guidance on how to interpret the improvement notation of the measure.
Short | Explanation of improvement notation
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQF Improvement Notation Guidance) (Extension Type: markdown)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
348. Measure.group.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
350. Measure.group.code
Definition | Indicates a meaning for the group. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing groups to be correlated across measures.
Short | Meaning of the group
Control | 0..1
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
352. Measure.group.description
Definition | The human readable description of this population group.
Short | Summary description
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
354. Measure.group.population
Definition | A population criteria for the measure.
Short | Population criteria
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
356. Measure.group.population.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
358. Measure.group.population.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
360. Measure.group.population.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
362. Measure.group.population.code
Definition | The type of population criteria.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType (extensible to `http://hl7.org/fhir/ValueSet/measure-population` ) The type of population.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
364. Measure.group.population.description
Definition | The human readable description of this population criteria.
Short | The human readable description of this population criteria
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
366. Measure.group.population.criteria
Definition | An expression that specifies the criteria for the population, typically the name of an expression in a library.
Short | The criteria that defines this population
Comments | In the case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
368. Measure.group.stratifier
Definition | The stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library or a valid FHIR Resource Path.
Short | Stratifier criteria for the measure
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
370. Measure.group.stratifier.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
372. Measure.group.stratifier.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
374. Measure.group.stratifier.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
376. Measure.group.stratifier.code
Definition | Indicates a meaning for the stratifier. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing stratifiers to be correlated across measures.
Short | Meaning of the stratifier
Control | 0..1
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
378. Measure.group.stratifier.description
Definition | The human readable description of this stratifier criteria.
Short | The human readable description of this stratifier
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
380. Measure.group.stratifier.criteria
Definition | An expression that specifies the criteria for the stratifier. This is typically the name of an expression defined within a referenced library, but it may also be a path to a stratifier element.
Short | How the measure should be stratified
Control | 0..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
382. Measure.group.stratifier.component
Definition | A component of the stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library or a valid FHIR Resource Path.
Short | Stratifier criteria component for the measure
Comments | Stratifiers are defined either as a single criteria, or as a set of component criteria.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
384. Measure.group.stratifier.component.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
386. Measure.group.stratifier.component.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
388. Measure.group.stratifier.component.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
390. Measure.group.stratifier.component.code
Definition | Indicates a meaning for the stratifier component. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing stratifiers to be correlated across measures.
Short | Meaning of the stratifier component
Control | 0..1
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
392. Measure.group.stratifier.component.description
Definition | The human readable description of this stratifier criteria component.
Short | The human readable description of this stratifier component
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
394. Measure.group.stratifier.component.criteria
Definition | An expression that specifies the criteria for this component of the stratifier. This is typically the name of an expression defined within a referenced library, but it may also be a path to a stratifier element.
Short | Component of how the measure should be stratified
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
396. Measure.supplementalData
Definition | The supplemental data criteria for the measure report, specified as either the name of a valid CQL expression within a referenced library, or a valid FHIR Resource Path.
Short | What other data should be reported with the measure
Comments | Note that supplemental data are reported as observations for each patient and included in the evaluatedResources bundle. See the MeasureReport resource or the Quality Reporting topic for more information.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
398. Measure.supplementalData.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
400. Measure.supplementalData.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Measure.supplementalData.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
402. Measure.supplementalData.extension:includeInReportType
Slice Name | includeInReportType
Definition | Indicates what types of report the element on which it appears should be included in. If no values are specified, the default behavior is that elements are included in all report types.
Short | The type of report the element should be included in
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(CQM Include In Report Type) (Extension Type: code)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
404. Measure.supplementalData.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
406. Measure.supplementalData.code
Definition | Indicates a meaning for the supplemental data. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing supplemental data to be correlated across measures.
Short | Meaning of the supplemental data
Control | 0..1
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
408. Measure.supplementalData.usage
Definition | An indicator of the intended usage for the supplemental data element. Supplemental data indicates the data is additional information requested to augment the measure information. Risk adjustment factor indicates the data is additional information used to calculate risk adjustment factors when applying a risk model to the measure calculation.
Short | supplemental-data | risk-adjustment-factor
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from MeasureDataUsage (extensible to `http://hl7.org/fhir/ValueSet/measure-data-usage` ) The intended usage for supplemental data elements in the measure.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
410. Measure.supplementalData.description
Definition | The human readable description of this supplemental data.
Short | The human readable description of this supplemental data
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
412. Measure.supplementalData.criteria
Definition | The criteria for the supplemental data. This is typically the name of a valid expression defined within a referenced library, but it may also be a path to a specific data element. The criteria defines the data to be returned for this element.
Short | Expression describing additional data to be reported
Control | 1..1
Type | Expression
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)