Data Exchange For Quality Measures Implementation Guide
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## Extension: DEQM Care Gap Remark Extension

Official URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-careGapRemark | Version: 1.0.0-ballot | Highlight text changes?
Standards status: Trial-use Active as of 2024-12-03 | Maturity Level: 4 | Computable Name: DEQMCareGapRemarkExtension

This extension allows a coded and/or narrative remark be added to a Care Gap's Individual Measure Report that adds context from a Provider about the gap.

Context of Use

This extension may be used on the following element(s)

- Element ID: `MeasureReport.group`

### Mandatory Data Elements and Terminology

The following data-elements are mandatory (i.e data MUST be present).

Each Must Have:

1. url: identifies the meaning of the extension

Usage info

Usages:

- Use this Extension: DEQM Individual MeasureReport Profile
- Examples for this Extension: MeasureReport/gaps-indv-measurereport04

You can also check for usages in the FHIR IG Statistics

### Formal Views of Extension Content

Description Differentials, Snapshots, and other representations.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension | C | 0..* | Extension | Condition Category remark Constraints: cgr-1
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:author |  | 0..1 | Extension | Identifier of the person who added the remark such as NPI
url |  | 1..1 | uri | "author"
value[x] |  | 1..1 |  | Identifier of the person who added the remark such as NPI
valueIdentifier |  |  | Identifier |
valueString |  |  | string |
extension:authorOrganization |  | 0..1 | Extension | Identifier of the organization that added the remark such as TIN, NPI.
url |  | 1..1 | uri | "authorOrganization"
value[x] |  | 1..1 |  | Value of extension
valueIdentifier |  |  | Identifier |
valueString |  |  | string |
valueReference |  |  | Reference(Organization) |
extension:authorSoftware |  | 0..1 | Extension | Identifier of the software that added the remark.
url |  | 1..1 | uri | "authorSoftware"
value[x] |  | 1..1 |  | Value of extension
valueIdentifier |  |  | Identifier |
valueString |  |  | string |
extension:authorDatetime |  | 0..1 | Extension | When the remark was added
url |  | 1..1 | uri | "authorDatetime"
value[x] |  | 1..1 | dateTime | Value of extension
extension:text |  | 0..* | Extension | Free text remark
url |  | 1..1 | uri | "text"
value[x] |  | 1..1 | string | Value of extension
extension:code |  | 0..1 | Extension | Coded remark
url |  | 1..1 | uri | "code"
value[x] |  | 1..1 | uri | Value of extension Binding: Care Gap Remark Value Set (extensible)
extension:relatedData |  | 0..* | Extension | Related data
url |  | 1..1 | uri | "relatedData"
value[x] |  | 1..1 |  | Value of extension
valueIdentifier |  |  | Identifier |
valueReference |  |  | Reference(Any) |
url |  | 1..1 | uri | "http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-careGapRemark"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Extension.extension:code.​value[x] | Base | extensible | Care Gap Remark Value Set | 📦1.0.0-ballot | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
cgr-1 | error | Extension | A remark shall include an author, an authorOrganization, or an authorSoftware | `extension.where(url = 'author').exists() or extension.where(url = 'authorOrganization').exists() or extension.where(url = 'authorSoftware').exists()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension | C | 0..* | Extension | Condition Category remark Constraints: cgr-1
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:author |  | 0..1 | Extension | Identifier of the person who added the remark such as NPI
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "author"
value[x] |  | 1..1 |  | Identifier of the person who added the remark such as NPI
valueIdentifier |  |  | Identifier |
valueString |  |  | string |
extension:authorOrganization |  | 0..1 | Extension | Identifier of the organization that added the remark such as TIN, NPI.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "authorOrganization"
value[x] |  | 1..1 |  | Value of extension
valueIdentifier |  |  | Identifier |
valueString |  |  | string |
valueReference |  |  | Reference(Organization) |
extension:authorSoftware |  | 0..1 | Extension | Identifier of the software that added the remark.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "authorSoftware"
value[x] |  | 1..1 |  | Value of extension
valueIdentifier |  |  | Identifier |
valueString |  |  | string |
extension:authorDatetime |  | 0..1 | Extension | When the remark was added
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "authorDatetime"
value[x] |  | 1..1 | dateTime | Value of extension
extension:text |  | 0..* | Extension | Free text remark
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "text"
value[x] |  | 1..1 | string | Value of extension
extension:code |  | 0..1 | Extension | Coded remark
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "code"
value[x] |  | 1..1 | uri | Value of extension Binding: Care Gap Remark Value Set (extensible)
extension:relatedData |  | 0..* | Extension | Related data
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "relatedData"
value[x] |  | 1..1 |  | Value of extension
valueIdentifier |  |  | Identifier |
valueReference |  |  | Reference(Any) |
url |  | 1..1 | uri | "http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-careGapRemark"
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Extension.extension:code.​value[x] | Base | extensible | Care Gap Remark Value Set | 📦1.0.0-ballot | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
cgr-1 | error | Extension | A remark shall include an author, an authorOrganization, or an authorSoftware | `extension.where(url = 'author').exists() or extension.where(url = 'authorOrganization').exists() or extension.where(url = 'authorSoftware').exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Summary

Complex Extension: This extension allows a coded and/or narrative remark be added to a Care Gap's Individual Measure Report that adds context from a Provider about the gap.

- author: Identifier, string: An Extension
- authorOrganization: Identifier, string, Reference: An Extension
- authorSoftware: Identifier, string: An Extension
- authorDatetime: dateTime: An Extension
- text: string: An Extension
- code: uri: An Extension
- relatedData: Identifier, Reference: An Extension

Maturity: 4

Differential ViewDifferential View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension | C | 0..* | Extension | Condition Category remark Constraints: cgr-1
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:author |  | 0..1 | Extension | Identifier of the person who added the remark such as NPI
url |  | 1..1 | uri | "author"
value[x] |  | 1..1 |  | Identifier of the person who added the remark such as NPI
valueIdentifier |  |  | Identifier |
valueString |  |  | string |
extension:authorOrganization |  | 0..1 | Extension | Identifier of the organization that added the remark such as TIN, NPI.
url |  | 1..1 | uri | "authorOrganization"
value[x] |  | 1..1 |  | Value of extension
valueIdentifier |  |  | Identifier |
valueString |  |  | string |
valueReference |  |  | Reference(Organization) |
extension:authorSoftware |  | 0..1 | Extension | Identifier of the software that added the remark.
url |  | 1..1 | uri | "authorSoftware"
value[x] |  | 1..1 |  | Value of extension
valueIdentifier |  |  | Identifier |
valueString |  |  | string |
extension:authorDatetime |  | 0..1 | Extension | When the remark was added
url |  | 1..1 | uri | "authorDatetime"
value[x] |  | 1..1 | dateTime | Value of extension
extension:text |  | 0..* | Extension | Free text remark
url |  | 1..1 | uri | "text"
value[x] |  | 1..1 | string | Value of extension
extension:code |  | 0..1 | Extension | Coded remark
url |  | 1..1 | uri | "code"
value[x] |  | 1..1 | uri | Value of extension Binding: Care Gap Remark Value Set (extensible)
extension:relatedData |  | 0..* | Extension | Related data
url |  | 1..1 | uri | "relatedData"
value[x] |  | 1..1 |  | Value of extension
valueIdentifier |  |  | Identifier |
valueReference |  |  | Reference(Any) |
url |  | 1..1 | uri | "http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-careGapRemark"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Extension.extension:code.​value[x] | Base | extensible | Care Gap Remark Value Set | 📦1.0.0-ballot | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
cgr-1 | error | Extension | A remark shall include an author, an authorOrganization, or an authorSoftware | `extension.where(url = 'author').exists() or extension.where(url = 'authorOrganization').exists() or extension.where(url = 'authorSoftware').exists()`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension | C | 0..* | Extension | Condition Category remark Constraints: cgr-1
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:author |  | 0..1 | Extension | Identifier of the person who added the remark such as NPI
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "author"
value[x] |  | 1..1 |  | Identifier of the person who added the remark such as NPI
valueIdentifier |  |  | Identifier |
valueString |  |  | string |
extension:authorOrganization |  | 0..1 | Extension | Identifier of the organization that added the remark such as TIN, NPI.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "authorOrganization"
value[x] |  | 1..1 |  | Value of extension
valueIdentifier |  |  | Identifier |
valueString |  |  | string |
valueReference |  |  | Reference(Organization) |
extension:authorSoftware |  | 0..1 | Extension | Identifier of the software that added the remark.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "authorSoftware"
value[x] |  | 1..1 |  | Value of extension
valueIdentifier |  |  | Identifier |
valueString |  |  | string |
extension:authorDatetime |  | 0..1 | Extension | When the remark was added
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "authorDatetime"
value[x] |  | 1..1 | dateTime | Value of extension
extension:text |  | 0..* | Extension | Free text remark
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "text"
value[x] |  | 1..1 | string | Value of extension
extension:code |  | 0..1 | Extension | Coded remark
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "code"
value[x] |  | 1..1 | uri | Value of extension Binding: Care Gap Remark Value Set (extensible)
extension:relatedData |  | 0..* | Extension | Related data
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "relatedData"
value[x] |  | 1..1 |  | Value of extension
valueIdentifier |  |  | Identifier |
valueReference |  |  | Reference(Any) |
url |  | 1..1 | uri | "http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-careGapRemark"
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Extension.extension:code.​value[x] | Base | extensible | Care Gap Remark Value Set | 📦1.0.0-ballot | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
cgr-1 | error | Extension | A remark shall include an author, an authorOrganization, or an authorSoftware | `extension.where(url = 'author').exists() or extension.where(url = 'authorOrganization').exists() or extension.where(url = 'authorSoftware').exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Summary

Complex Extension: This extension allows a coded and/or narrative remark be added to a Care Gap's Individual Measure Report that adds context from a Provider about the gap.

- author: Identifier, string: An Extension
- authorOrganization: Identifier, string, Reference: An Extension
- authorSoftware: Identifier, string: An Extension
- authorDatetime: dateTime: An Extension
- text: string: An Extension
- code: uri: An Extension
- relatedData: Identifier, Reference: An Extension

Maturity: 4

Other representations of profile: CSV, Excel, Schematron