Data Exchange For Quality Measures Implementation Guide
1.0.0-ballot - STU 1 Ballot

Data Exchange For Quality Measures Implementation Guide - Downloaded Version 1.0.0-ballot See the Directory of published versions

## Resource Profile: DEQM Summary MeasureReport Profile

Official URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-summarymeasurereport | Version: 1.0.0-ballot | Highlight text changes?
Standards status: Trial-use Active as of 2018-06-19 | Maturity Level: 4 | Computable Name: DEQMSummaryMeasureReportProfile

MeasureReport is used as an organizer for both data exchange for measure and for measure reporting. Three profiles on the MeasureReport resource are defined in this guide to delineate these different uses. The DEQM Summary MeasureReport Profile defined here is used when a measure is reported to an aggregator for a group of subjects. It contains all of the data that is relevant to generate the report including the measure outcome and is similar to a QRDA Category 3 report. Unlike the DEQM Individual MeasureReport Profile, the report is typically transacted as a single MeasureReport report.

### Mandatory Data Elements and Terminology

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

Each MeasureReport Must Have:

1. measure: What measure and version was calculated
2. reporter: Organization that generated the MeasureReport
3. period.start: Starting time with inclusive boundary
4. status: complete | pending | error
5. type: individual | subject-list | summary | data-collection
6. period.end: End time with inclusive boundary, if not ongoing
7. date: When the report was generated. Note: The language in R5 was changed to calculated. We are clarifying that intent.
8. group: Measure results for each group
9. period: What period the report covers

Each MeasureReport Must Support:

1. group.id: Unique id for inter-element referencing
2. group.stratifier.code: What stratifier of the group
3. description: Description of the stratifier
4. description: Description of the population
5. group.stratifier.stratum: Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
6. countQuantity: Count as a Quantity
7. category: What category is this measure report
8. group.population: The populations in the group
9. improvementNotation: increase | decrease
10. group.measureScore: What score this group achieved
11. group.population.count: Size of the population
12. scoring: proportion | ratio | continuous-variable | cohort | composite | attestation
13. calculatedDate: The date the score was calculated
14. alternateScoreType: Possible additional measureScore value types
15. description: Description of the group
16. countQuantity: Size of the population as a quantity.
17. group.stratifier: Stratification results
18. supplementalData: Optional Extensions Element
19. group.stratifier.stratum.value: The stratum value, e.g. male
20. group.stratifier.stratum.population: Population results in this stratum
21. group.stratifier.stratum.measureScore: What score this stratum achieved
22. group.code: Meaning of the group

Additional Profile specific implementation guidance:

- The `MeasureReport.group.population.id` is a must support element because it is used to link across the Measure and is equal to the `Measure.group.population.id`. This is needed because the `MeasureReport.group.population.code` is insufficient when the measure types have multiple populations with the same code.

- If the measure scoring type is 'proportion', 'ratio', or 'continuous-variable' then the `improvementNotation` element is required.

- If the measure scoring type is 'proportion' then the `MeasureReport.group.measureScore.value` SHALL be a numerical value between 0 and 1.

- The `reporter` should be consistent with the X-Provenance header data if present.

- the DEQM Reporting Vendor Extension is intended to represent the submitting entity when it is not the same as the reporting entity.

- There are some elements like scoring and improvementNotation that can be specified either at the measure level or at the group level. If it is reported at the measure level it should not be specified for any group and if it is specified for any group it should be specified for every group and not at the measure level.

### Examples

- Measurereport Summ Measurereport01
- Measurereport Summ Measurereport02
- Measurereport Summ MeasureReportContainedSupplemental
- Measurereport Summ Attestation

Usages:

- Examples for this Profile: MeasureReport/MeasureReport-PI-example, MeasureReport/attestation-boolean-example, MeasureReport/date-of-last-power-outage, MeasureReport/summ-contained-supplemental... Show 5 more, MeasureReport/summ-measurereport01, MeasureReport/summ-measurereport02, MeasureReport/summ-medicare-stratification-example, MeasureReport/summary-measurereport-patient-level-linear and MeasureReport/summary-measurereport-weighted-composite
- CapabilityStatements using this Profile: Receiver Server CapabilityStatement and Reporter Client CapabilityStatement

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MeasureReport | C | 0..* | MeasureReport | Results of a measure evaluation Constraints: mrp-1, mrp-2, deqm-2, deqm-3, deqm-5
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:reportingProgram |  | 0..1 | Identifier, canonical(CRMI Manifest Library) | Reporting program URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingProgram
extension:category | S | 0..1 | CodeableConcept | What category is this measure report URL: http://hl7.org/fhir/StructureDefinition/measurereport-category Binding: MeasureReportCategory (extensible)
extension:inputParameters |  | 0..1 | Reference(Parameters) | What parameters URL: http://hl7.org/fhir/StructureDefinition/cqf-inputParameters
extension:supplementalData | S | 0..* | (Complex) | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.supplementalData
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.supplementalData"
value[x] |  | 1..1 | Reference(Resource) | Value of extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
extension:description | S | 0..1 | markdown | Description of the supplemental data URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
extension:scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort | composite | attestation URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring Binding: Measure Scoring (extensible)
extension:vendor |  | 0..1 | Reference(Organization) | Vendor information URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingVendor
extension:location |  | 0..* | Reference(Location) | Location(s) from which reported data was gathered URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-dataLocation
extension:cehrt |  | 0..1 | (Complex) | CMS EHR Certification ID URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-certificationIdentifier
url |  | 1..1 | uri | "http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-certificationIdentifier"
Slices for value[x] |  | 1..1 | Identifier | Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueIdentifier |  | 1..1 | Identifier | Value of extension Required Pattern: At least the following
extension:software |  | 0..* | Reference(CRMI Software System Device) | Extension URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem
extension:message |  | 0..1 | Reference(OperationOutcome) | Evaluation messages URL: http://hl7.org/fhir/StructureDefinition/cqf-messages
extension:limitations | S | 0..1 | markdown | identifies what limitations should be noted, including potential selection biases and confounding factors when interpreting indicator results or comparing results across the country. If the extension is present in the Measure, then it SHALL be in the MeasureReport (MustSupport) and SHALL at least contain a copy of the content from the Measure. It is permissible to add content to the extensions in the MeasureReport. URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-limitations
extension:trendingIssues | S | 0..1 | markdown | 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). If the extension is present in the Measure, then it SHALL be in the MeasureReport (MustSupport) and SHALL at least contain a copy of the content from the Measure. It is permissible to add content to the extensions in the MeasureReport. URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-trendingIssues
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | complete | pending | error Binding: MeasureReportStatus (required)
type | S Σ C | 1..1 | code | individual | subject-list | summary | data-collection Binding: MeasureReportType (required): The type of the measure report. Fixed Value: summary
measure | S Σ C | 1..1 | canonical(CRMI Shareable Measure) | What measure and version was calculated Constraints: deqm-0
subject | Σ | 0..1 | Reference(Group) | What group the report is for.
date | S Σ | 1..1 | dateTime | When the report was generated. Note: The language in R5 was changed to calculated. We are clarifying that intent.
reporter | S Σ | 1..1 | Reference(Organization | Practitioner | PractitionerRole) | Who is reporting the data. The reporter is the entity fulfilling the reporting requirement.
period | S Σ C | 1..1 | Period | What period the report covers Constraints: deqm-1
start | S Σ C | 1..1 | dateTime | Starting time with inclusive boundary
end | S Σ C | 1..1 | dateTime | End time with inclusive boundary, if not ongoing
improvementNotation | ?!S Σ C | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.
group | S C | 1..* | BackboneElement | Measure results for each group Constraints: deqm-4, deqm-6
id | S | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the group from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.linkId
extension:scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort | composite | attestation URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring Binding: Measure Scoring (extensible)
extension:cqm-compositeScoring | S | 0..1 | CodeableConcept | How the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
extension:calculatedDate | S | 0..1 | dateTime | The date the score was calculated URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-calculatedDate
extension:improvementNotation | S C | 0..1 | CodeableConcept | increase | decrease URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-groupImprovementNotation Binding: MeasureImprovementNotation (extensible)
extension:description | S | 0..1 | markdown | Description of the group URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 0..1 | CodeableConcept | Meaning of the group
population | S C | 0..* | BackboneElement | The populations in the group Constraints: deqm-8
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id for group.population from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.population.linkId
extension:countQuantity | S C | 0..1 | Quantity | Count as a Quantity URL: http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity
extension:description | S | 0..1 | markdown | Description of the population URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.).
count | S C | 0..1 | integer | Size of the population
measureScore | S Σ C | 0..1 | Quantity | What score this group achieved
Slices for extension |  |  |  | Content/Rules for all slices
extension:alternateScoreType | S | 0..1 | dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio | Possible additional measureScore value types URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
stratifier | S C | 0..* | BackboneElement | Stratification results Constraints: deqm-7
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id for group.stratifier from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.linkId
extension:description | S | 0..1 | markdown | Description of the stratifier URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | What stratifier of the group
stratum | S | 0..* | BackboneElement | Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
value | S | 0..1 | CodeableConcept | The stratum value, e.g. male
component |  | 0..* | BackboneElement | Stratifier component values
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id for group.stratifier.component from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.component.linkId
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 1..1 | CodeableConcept | What stratifier component of the group
value |  | 1..1 | CodeableConcept | The stratum component value, e.g. male
population | S C | 0..* | BackboneElement | Population results in this stratum Constraints: deqm-9
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id for group.stratifier.population from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.population.linkId
extension:countQuantity | S C | 0..1 | Quantity | Size of the population as a quantity. URL: http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.).
count | S C | 1..1 | integer | Size of the population
measureScore | S | 0..1 | Quantity | What score this stratum achieved
Slices for extension |  |  |  | Content/Rules for all slices
extension:alternateScoreType | S | 0..1 | dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio | Possible additional measureScore value types URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MeasureReport.status | Base | required | MeasureReportStatus | 📦4.0.1 | FHIR Std.
MeasureReport.type | Base | required | MeasureReportType | 📍4.0.1 | FHIR Std.
MeasureReport.improvementNotation | Base | required | MeasureImprovementNotation | 📍4.0.1 | FHIR Std.
MeasureReport.group.​population.code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
MeasureReport.group.​measureScore.comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
MeasureReport.group.​stratifier.stratum.population.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
MeasureReport.group.​stratifier.stratum.measureScore.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
deqm-0 | error | MeasureReport.measure | Canonical URL SHALL contain a version. | `%resource.measure.toString().contains('|') and %resource.measure.substring(%resource.measure.toString().indexOf('|') + 1).length() > 0`
deqm-1 | error | MeasureReport.period | Date precision SHALL be at least to day ( YYYY-MM-DD ) | `start.toString().length()>9 and end.toString().length()>9`
deqm-2 | error | MeasureReport | If the measure scoring is specified at the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists().anyTrue() and extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable')).anyTrue() implies improvementNotation.exists()`
deqm-3 | error | MeasureReport | Measure scoring is required. It must be specified on the root only, or on every group, and it cannot be on both. | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists() and group.extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').empty()) xor (extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').empty() and group.all(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists()))`
deqm-4 | error | MeasureReport.group | If the measure scoring is specified on the group and the scoring type is 'proportion', 'ratio' or 'continuous-variable' then the groupImprovementNotation element is required. | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists().anyTrue() and extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable')).anyTrue() implies extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-groupImprovementNotation').exists()`
deqm-5 | error | MeasureReport | If the scoring, at either the root level or the group level, is other than composite then the group.population cardinality is >=1 | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains ('composite')).not().anyTrue() or (group.extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains ('composite')).not().anyTrue() implies group.population.count()>=1`
deqm-6 | error | MeasureReport.group | If the measure scoring type is 'proportion' then the measureScore SHALL be a numerical value between 0 and 1 | `((%resource.extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains 'proportion').anyTrue() or extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains 'proportion').anyTrue() implies (measureScore.value >= 0.0 and measureScore.value <= 1.0)`
deqm-7 | error | MeasureReport.group.stratifier | If group.stratifier exists, then either group.stratifier.code or the group.stratifier.stratum.component.code is present, but not both | `code.exists() xor stratum.component.exists()`
deqm-8 | error | MeasureReport.group.population | The population must either have a count (integer) or a countQuantity (quantity), but not both. | `extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists()`
deqm-9 | error | MeasureReport.group.stratifier.stratum.population | The stratum population must either have a count (integer) or a countQuantity (quantity), but not both. | `extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists()`
dom-2 | error | MeasureReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MeasureReport | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MeasureReport | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MeasureReport | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MeasureReport | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mrp-1 | error | MeasureReport | Measure Reports used for data collection SHALL NOT communicate group and score information | `(type != 'data-collection') or group.exists().not()`
mrp-2 | error | MeasureReport | Stratifiers SHALL be either a single criteria or a set of criteria components | `group.stratifier.stratum.all(value.exists() xor component.exists())`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MeasureReport | C | 0..* | MeasureReport | Results of a measure evaluation Constraints: deqm-2, deqm-3, deqm-5
Slices for extension |  |  |  | Content/Rules for all slices
extension:reportingProgram |  | 0..1 | Identifier, canonical(CRMI Manifest Library) | Reporting program URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingProgram
extension:category | S | 0..1 | CodeableConcept | What category is this measure report URL: http://hl7.org/fhir/StructureDefinition/measurereport-category Binding: MeasureReportCategory (extensible)
extension:inputParameters |  | 0..1 | Reference(Parameters) | What parameters URL: http://hl7.org/fhir/StructureDefinition/cqf-inputParameters
extension:supplementalData | S | 0..* | (Complex) | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.supplementalData
value[x] |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
extension:description | S | 0..1 | markdown | Description of the supplemental data URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
extension:scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort | composite | attestation URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring Binding: Measure Scoring (extensible)
extension:vendor |  | 0..1 | Reference(Organization) | Vendor information URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingVendor
extension:location |  | 0..* | Reference(Location) | Location(s) from which reported data was gathered URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-dataLocation
extension:cehrt |  | 0..1 | (Complex) | CMS EHR Certification ID URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-certificationIdentifier
valueIdentifier |  | 1..1 | Identifier | Value of extension Required Pattern: At least the following
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: urn:oid:2.16.840.1.113883.3.2074.1
extension:software |  | 0..* | Reference(CRMI Software System Device) | Extension URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem
extension:message |  | 0..1 | Reference(OperationOutcome) | Evaluation messages URL: http://hl7.org/fhir/StructureDefinition/cqf-messages
extension:limitations | S | 0..1 | markdown | identifies what limitations should be noted, including potential selection biases and confounding factors when interpreting indicator results or comparing results across the country. If the extension is present in the Measure, then it SHALL be in the MeasureReport (MustSupport) and SHALL at least contain a copy of the content from the Measure. It is permissible to add content to the extensions in the MeasureReport. URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-limitations
extension:trendingIssues | S | 0..1 | markdown | 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). If the extension is present in the Measure, then it SHALL be in the MeasureReport (MustSupport) and SHALL at least contain a copy of the content from the Measure. It is permissible to add content to the extensions in the MeasureReport. URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-trendingIssues
status | S | 1..1 | code | complete | pending | error Binding: MeasureReportStatus (required)
type | S | 1..1 | code | individual | subject-list | summary | data-collection Fixed Value: summary
measure | S C | 1..1 | canonical(CRMI Shareable Measure) | What measure and version was calculated Constraints: deqm-0
subject |  | 0..1 | Reference(Group) | What group the report is for.
date | S | 1..1 | dateTime | When the report was generated. Note: The language in R5 was changed to calculated. We are clarifying that intent.
reporter | S | 1..1 | Reference(Organization | Practitioner | PractitionerRole) | Who is reporting the data. The reporter is the entity fulfilling the reporting requirement.
period | S C | 1..1 | Period | What period the report covers Constraints: deqm-1
start | S | 1..1 | dateTime | Starting time with inclusive boundary
end | S | 1..1 | dateTime | End time with inclusive boundary, if not ongoing
improvementNotation | S C | 0..1 | CodeableConcept | increase | decrease
group | S C | 1..* | BackboneElement | Measure results for each group Constraints: deqm-4, deqm-6
id | S | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  |  |  | Content/Rules for all slices
extension:linkId | S | 1..1 | string | Unique id of the group from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.linkId
extension:scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort | composite | attestation URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring Binding: Measure Scoring (extensible)
extension:cqm-compositeScoring | S | 0..1 | CodeableConcept | How the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
extension:calculatedDate | S | 0..1 | dateTime | The date the score was calculated URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-calculatedDate
extension:improvementNotation | S C | 0..1 | CodeableConcept | increase | decrease URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-groupImprovementNotation Binding: MeasureImprovementNotation (extensible)
extension:description | S | 0..1 | markdown | Description of the group URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
code | S | 0..1 | CodeableConcept | Meaning of the group
population | S C | 0..* | BackboneElement | The populations in the group Constraints: deqm-8
Slices for extension |  |  |  | Content/Rules for all slices
extension:linkId | S | 1..1 | string | Unique id for group.population from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.population.linkId
extension:countQuantity | S C | 0..1 | Quantity | Count as a Quantity URL: http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity
extension:description | S | 0..1 | markdown | Description of the population URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
count | S C | 0..1 | integer | Size of the population
subjectResults |  | 0..0 |  | For subject-list reports, the subject results in this population
measureScore | S C | 0..1 | Quantity | What score this group achieved
Slices for extension |  |  |  | Content/Rules for all slices
extension:alternateScoreType | S | 0..1 | dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio | Possible additional measureScore value types URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType
stratifier | S C | 0..* | BackboneElement | Stratification results Constraints: deqm-7
Slices for extension |  |  |  | Content/Rules for all slices
extension:linkId | S | 1..1 | string | Unique id for group.stratifier from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.linkId
extension:description | S | 0..1 | markdown | Description of the stratifier URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
code | S | 0..1 | CodeableConcept | What stratifier of the group
stratum | S | 0..* | BackboneElement | Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
value | S | 0..1 | CodeableConcept | The stratum value, e.g. male
component |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:linkId | S | 1..1 | string | Unique id for group.stratifier.component from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.component.linkId
population | S C | 0..* | BackboneElement | Population results in this stratum Constraints: deqm-9
Slices for extension |  |  |  | Content/Rules for all slices
extension:linkId | S | 1..1 | string | Unique id for group.stratifier.population from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.population.linkId
extension:countQuantity | S C | 0..1 | Quantity | Size of the population as a quantity. URL: http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
count | S C | 1..1 | integer | Size of the population
subjectResults |  | 0..0 |  | For subject-list reports, the subject results in this population
measureScore | S | 0..1 | Quantity | What score this stratum achieved
Slices for extension |  |  |  | Content/Rules for all slices
extension:alternateScoreType | S | 0..1 | dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio | Possible additional measureScore value types URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType
evaluatedResource |  | 0..0 |  | What data was used to calculate the measure score
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MeasureReport.status | Base | required | MeasureReportStatus | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
deqm-0 | error | MeasureReport.measure | Canonical URL SHALL contain a version. | `%resource.measure.toString().contains('|') and %resource.measure.substring(%resource.measure.toString().indexOf('|') + 1).length() > 0`
deqm-1 | error | MeasureReport.period | Date precision SHALL be at least to day ( YYYY-MM-DD ) | `start.toString().length()>9 and end.toString().length()>9`
deqm-2 | error | MeasureReport | If the measure scoring is specified at the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists().anyTrue() and extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable')).anyTrue() implies improvementNotation.exists()`
deqm-3 | error | MeasureReport | Measure scoring is required. It must be specified on the root only, or on every group, and it cannot be on both. | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists() and group.extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').empty()) xor (extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').empty() and group.all(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists()))`
deqm-4 | error | MeasureReport.group | If the measure scoring is specified on the group and the scoring type is 'proportion', 'ratio' or 'continuous-variable' then the groupImprovementNotation element is required. | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists().anyTrue() and extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable')).anyTrue() implies extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-groupImprovementNotation').exists()`
deqm-5 | error | MeasureReport | If the scoring, at either the root level or the group level, is other than composite then the group.population cardinality is >=1 | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains ('composite')).not().anyTrue() or (group.extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains ('composite')).not().anyTrue() implies group.population.count()>=1`
deqm-6 | error | MeasureReport.group | If the measure scoring type is 'proportion' then the measureScore SHALL be a numerical value between 0 and 1 | `((%resource.extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains 'proportion').anyTrue() or extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains 'proportion').anyTrue() implies (measureScore.value >= 0.0 and measureScore.value <= 1.0)`
deqm-7 | error | MeasureReport.group.stratifier | If group.stratifier exists, then either group.stratifier.code or the group.stratifier.stratum.component.code is present, but not both | `code.exists() xor stratum.component.exists()`
deqm-8 | error | MeasureReport.group.population | The population must either have a count (integer) or a countQuantity (quantity), but not both. | `extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists()`
deqm-9 | error | MeasureReport.group.stratifier.stratum.population | The stratum population must either have a count (integer) or a countQuantity (quantity), but not both. | `extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MeasureReport | C | 0..* | MeasureReport | Results of a measure evaluation Constraints: mrp-1, mrp-2, deqm-2, deqm-3, deqm-5
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:reportingProgram |  | 0..1 | Identifier, canonical(CRMI Manifest Library) | Reporting program URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingProgram
extension:category | S | 0..1 | CodeableConcept | What category is this measure report URL: http://hl7.org/fhir/StructureDefinition/measurereport-category Binding: MeasureReportCategory (extensible)
extension:inputParameters |  | 0..1 | Reference(Parameters) | What parameters URL: http://hl7.org/fhir/StructureDefinition/cqf-inputParameters
extension:supplementalData | S | 0..* | (Complex) | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.supplementalData
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.supplementalData"
value[x] |  | 1..1 | Reference(Resource) | Value of extension
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
extension:description | S | 0..1 | markdown | Description of the supplemental data URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
extension:scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort | composite | attestation URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring Binding: Measure Scoring (extensible)
extension:vendor |  | 0..1 | Reference(Organization) | Vendor information URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingVendor
extension:location |  | 0..* | Reference(Location) | Location(s) from which reported data was gathered URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-dataLocation
extension:cehrt |  | 0..1 | (Complex) | CMS EHR Certification ID URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-certificationIdentifier
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 | "http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-certificationIdentifier"
Slices for value[x] |  | 1..1 | Identifier | Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueIdentifier |  | 1..1 | Identifier | Value of extension Required Pattern: At least the following
extension:software |  | 0..* | Reference(CRMI Software System Device) | Extension URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem
extension:message |  | 0..1 | Reference(OperationOutcome) | Evaluation messages URL: http://hl7.org/fhir/StructureDefinition/cqf-messages
extension:limitations | S | 0..1 | markdown | identifies what limitations should be noted, including potential selection biases and confounding factors when interpreting indicator results or comparing results across the country. If the extension is present in the Measure, then it SHALL be in the MeasureReport (MustSupport) and SHALL at least contain a copy of the content from the Measure. It is permissible to add content to the extensions in the MeasureReport. URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-limitations
extension:trendingIssues | S | 0..1 | markdown | 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). If the extension is present in the Measure, then it SHALL be in the MeasureReport (MustSupport) and SHALL at least contain a copy of the content from the Measure. It is permissible to add content to the extensions in the MeasureReport. URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-trendingIssues
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Additional identifier for the MeasureReport
status | ?!S Σ | 1..1 | code | complete | pending | error Binding: MeasureReportStatus (required)
type | S Σ C | 1..1 | code | individual | subject-list | summary | data-collection Binding: MeasureReportType (required): The type of the measure report. Fixed Value: summary
measure | S Σ C | 1..1 | canonical(CRMI Shareable Measure) | What measure and version was calculated Constraints: deqm-0
subject | Σ | 0..1 | Reference(Group) | What group the report is for.
date | S Σ | 1..1 | dateTime | When the report was generated. Note: The language in R5 was changed to calculated. We are clarifying that intent.
reporter | S Σ | 1..1 | Reference(Organization | Practitioner | PractitionerRole) | Who is reporting the data. The reporter is the entity fulfilling the reporting requirement.
period | S Σ C | 1..1 | Period | What period the report covers Constraints: deqm-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
start | S Σ C | 1..1 | dateTime | Starting time with inclusive boundary
end | S Σ C | 1..1 | dateTime | End time with inclusive boundary, if not ongoing
improvementNotation | ?!S Σ C | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.
group | S C | 1..* | BackboneElement | Measure results for each group Constraints: deqm-4, deqm-6
id | S | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the group from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.linkId
extension:scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort | composite | attestation URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring Binding: Measure Scoring (extensible)
extension:cqm-compositeScoring | S | 0..1 | CodeableConcept | How the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
extension:calculatedDate | S | 0..1 | dateTime | The date the score was calculated URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-calculatedDate
extension:improvementNotation | S C | 0..1 | CodeableConcept | increase | decrease URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-groupImprovementNotation Binding: MeasureImprovementNotation (extensible)
extension:description | S | 0..1 | markdown | Description of the group URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 0..1 | CodeableConcept | Meaning of the group
population | S C | 0..* | BackboneElement | The populations in the group Constraints: deqm-8
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id for group.population from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.population.linkId
extension:countQuantity | S C | 0..1 | Quantity | Count as a Quantity URL: http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity
extension:description | S | 0..1 | markdown | Description of the population URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.).
count | S C | 0..1 | integer | Size of the population
measureScore | S Σ C | 0..1 | Quantity | What score this group achieved
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:alternateScoreType | S | 0..1 | dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio | Possible additional measureScore value types URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType
value | Σ | 0..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | Σ | 0..1 | string | Unit representation
system | Σ C | 0..1 | uri | System that defines coded unit form
code | Σ | 0..1 | code | Coded form of the unit
stratifier | S C | 0..* | BackboneElement | Stratification results Constraints: deqm-7
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id for group.stratifier from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.linkId
extension:description | S | 0..1 | markdown | Description of the stratifier URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | What stratifier of the group
stratum | S | 0..* | BackboneElement | Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
value | S | 0..1 | CodeableConcept | The stratum value, e.g. male
component |  | 0..* | BackboneElement | Stratifier component values
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id for group.stratifier.component from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.component.linkId
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 1..1 | CodeableConcept | What stratifier component of the group
value |  | 1..1 | CodeableConcept | The stratum component value, e.g. male
population | S C | 0..* | BackboneElement | Population results in this stratum Constraints: deqm-9
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id for group.stratifier.population from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.population.linkId
extension:countQuantity | S C | 0..1 | Quantity | Size of the population as a quantity. URL: http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.).
count | S C | 1..1 | integer | Size of the population
measureScore | S | 0..1 | Quantity | What score this stratum achieved
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:alternateScoreType | S | 0..1 | dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio | Possible additional measureScore value types URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType
value | Σ | 0..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | Σ | 0..1 | string | Unit representation
system | Σ C | 0..1 | uri | System that defines coded unit form
code | Σ | 0..1 | code | Coded form of the unit
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MeasureReport.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MeasureReport.extension:supplementalData.​value[x].type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
MeasureReport.status | Base | required | MeasureReportStatus | 📦4.0.1 | FHIR Std.
MeasureReport.type | Base | required | MeasureReportType | 📍4.0.1 | FHIR Std.
MeasureReport.improvementNotation | Base | required | MeasureImprovementNotation | 📍4.0.1 | FHIR Std.
MeasureReport.group.​population.code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
MeasureReport.group.​measureScore.comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
MeasureReport.group.​stratifier.stratum.population.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
MeasureReport.group.​stratifier.stratum.measureScore.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
deqm-0 | error | MeasureReport.measure | Canonical URL SHALL contain a version. | `%resource.measure.toString().contains('|') and %resource.measure.substring(%resource.measure.toString().indexOf('|') + 1).length() > 0`
deqm-1 | error | MeasureReport.period | Date precision SHALL be at least to day ( YYYY-MM-DD ) | `start.toString().length()>9 and end.toString().length()>9`
deqm-2 | error | MeasureReport | If the measure scoring is specified at the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists().anyTrue() and extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable')).anyTrue() implies improvementNotation.exists()`
deqm-3 | error | MeasureReport | Measure scoring is required. It must be specified on the root only, or on every group, and it cannot be on both. | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists() and group.extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').empty()) xor (extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').empty() and group.all(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists()))`
deqm-4 | error | MeasureReport.group | If the measure scoring is specified on the group and the scoring type is 'proportion', 'ratio' or 'continuous-variable' then the groupImprovementNotation element is required. | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists().anyTrue() and extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable')).anyTrue() implies extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-groupImprovementNotation').exists()`
deqm-5 | error | MeasureReport | If the scoring, at either the root level or the group level, is other than composite then the group.population cardinality is >=1 | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains ('composite')).not().anyTrue() or (group.extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains ('composite')).not().anyTrue() implies group.population.count()>=1`
deqm-6 | error | MeasureReport.group | If the measure scoring type is 'proportion' then the measureScore SHALL be a numerical value between 0 and 1 | `((%resource.extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains 'proportion').anyTrue() or extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains 'proportion').anyTrue() implies (measureScore.value >= 0.0 and measureScore.value <= 1.0)`
deqm-7 | error | MeasureReport.group.stratifier | If group.stratifier exists, then either group.stratifier.code or the group.stratifier.stratum.component.code is present, but not both | `code.exists() xor stratum.component.exists()`
deqm-8 | error | MeasureReport.group.population | The population must either have a count (integer) or a countQuantity (quantity), but not both. | `extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists()`
deqm-9 | error | MeasureReport.group.stratifier.stratum.population | The stratum population must either have a count (integer) or a countQuantity (quantity), but not both. | `extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists()`
dom-2 | error | MeasureReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MeasureReport | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MeasureReport | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MeasureReport | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MeasureReport | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mrp-1 | error | MeasureReport | Measure Reports used for data collection SHALL NOT communicate group and score information | `(type != 'data-collection') or group.exists().not()`
mrp-2 | error | MeasureReport | Stratifiers SHALL be either a single criteria or a set of criteria components | `group.stratifier.stratum.all(value.exists() xor component.exists())`

Summary

Mandatory: 7 elements(8 nested mandatory elements)
Must-Support: 47 elements
Fixed: 1 element
Prohibited: 3 elements

Structures

This structure refers to these other structures:

- CRMI Shareable Measure (http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingProgram
- http://hl7.org/fhir/StructureDefinition/measurereport-category
- http://hl7.org/fhir/StructureDefinition/cqf-inputParameters
- http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.supplementalData
- http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
- http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
- http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring
- http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingVendor
- http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-dataLocation
- http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-certificationIdentifier
- http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem
- http://hl7.org/fhir/StructureDefinition/cqf-messages
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-limitations
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-trendingIssues
- http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.linkId
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring
- http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-calculatedDate
- http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-groupImprovementNotation
- http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.population.linkId
- http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity
- http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType
- http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.linkId
- http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.component.linkId
- http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.population.linkId

Maturity: 4

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MeasureReport | C | 0..* | MeasureReport | Results of a measure evaluation Constraints: mrp-1, mrp-2, deqm-2, deqm-3, deqm-5
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:reportingProgram |  | 0..1 | Identifier, canonical(CRMI Manifest Library) | Reporting program URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingProgram
extension:category | S | 0..1 | CodeableConcept | What category is this measure report URL: http://hl7.org/fhir/StructureDefinition/measurereport-category Binding: MeasureReportCategory (extensible)
extension:inputParameters |  | 0..1 | Reference(Parameters) | What parameters URL: http://hl7.org/fhir/StructureDefinition/cqf-inputParameters
extension:supplementalData | S | 0..* | (Complex) | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.supplementalData
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.supplementalData"
value[x] |  | 1..1 | Reference(Resource) | Value of extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
extension:description | S | 0..1 | markdown | Description of the supplemental data URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
extension:scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort | composite | attestation URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring Binding: Measure Scoring (extensible)
extension:vendor |  | 0..1 | Reference(Organization) | Vendor information URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingVendor
extension:location |  | 0..* | Reference(Location) | Location(s) from which reported data was gathered URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-dataLocation
extension:cehrt |  | 0..1 | (Complex) | CMS EHR Certification ID URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-certificationIdentifier
url |  | 1..1 | uri | "http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-certificationIdentifier"
Slices for value[x] |  | 1..1 | Identifier | Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueIdentifier |  | 1..1 | Identifier | Value of extension Required Pattern: At least the following
extension:software |  | 0..* | Reference(CRMI Software System Device) | Extension URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem
extension:message |  | 0..1 | Reference(OperationOutcome) | Evaluation messages URL: http://hl7.org/fhir/StructureDefinition/cqf-messages
extension:limitations | S | 0..1 | markdown | identifies what limitations should be noted, including potential selection biases and confounding factors when interpreting indicator results or comparing results across the country. If the extension is present in the Measure, then it SHALL be in the MeasureReport (MustSupport) and SHALL at least contain a copy of the content from the Measure. It is permissible to add content to the extensions in the MeasureReport. URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-limitations
extension:trendingIssues | S | 0..1 | markdown | 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). If the extension is present in the Measure, then it SHALL be in the MeasureReport (MustSupport) and SHALL at least contain a copy of the content from the Measure. It is permissible to add content to the extensions in the MeasureReport. URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-trendingIssues
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | complete | pending | error Binding: MeasureReportStatus (required)
type | S Σ C | 1..1 | code | individual | subject-list | summary | data-collection Binding: MeasureReportType (required): The type of the measure report. Fixed Value: summary
measure | S Σ C | 1..1 | canonical(CRMI Shareable Measure) | What measure and version was calculated Constraints: deqm-0
subject | Σ | 0..1 | Reference(Group) | What group the report is for.
date | S Σ | 1..1 | dateTime | When the report was generated. Note: The language in R5 was changed to calculated. We are clarifying that intent.
reporter | S Σ | 1..1 | Reference(Organization | Practitioner | PractitionerRole) | Who is reporting the data. The reporter is the entity fulfilling the reporting requirement.
period | S Σ C | 1..1 | Period | What period the report covers Constraints: deqm-1
start | S Σ C | 1..1 | dateTime | Starting time with inclusive boundary
end | S Σ C | 1..1 | dateTime | End time with inclusive boundary, if not ongoing
improvementNotation | ?!S Σ C | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.
group | S C | 1..* | BackboneElement | Measure results for each group Constraints: deqm-4, deqm-6
id | S | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the group from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.linkId
extension:scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort | composite | attestation URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring Binding: Measure Scoring (extensible)
extension:cqm-compositeScoring | S | 0..1 | CodeableConcept | How the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
extension:calculatedDate | S | 0..1 | dateTime | The date the score was calculated URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-calculatedDate
extension:improvementNotation | S C | 0..1 | CodeableConcept | increase | decrease URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-groupImprovementNotation Binding: MeasureImprovementNotation (extensible)
extension:description | S | 0..1 | markdown | Description of the group URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 0..1 | CodeableConcept | Meaning of the group
population | S C | 0..* | BackboneElement | The populations in the group Constraints: deqm-8
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id for group.population from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.population.linkId
extension:countQuantity | S C | 0..1 | Quantity | Count as a Quantity URL: http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity
extension:description | S | 0..1 | markdown | Description of the population URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.).
count | S C | 0..1 | integer | Size of the population
measureScore | S Σ C | 0..1 | Quantity | What score this group achieved
Slices for extension |  |  |  | Content/Rules for all slices
extension:alternateScoreType | S | 0..1 | dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio | Possible additional measureScore value types URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
stratifier | S C | 0..* | BackboneElement | Stratification results Constraints: deqm-7
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id for group.stratifier from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.linkId
extension:description | S | 0..1 | markdown | Description of the stratifier URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | What stratifier of the group
stratum | S | 0..* | BackboneElement | Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
value | S | 0..1 | CodeableConcept | The stratum value, e.g. male
component |  | 0..* | BackboneElement | Stratifier component values
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id for group.stratifier.component from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.component.linkId
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 1..1 | CodeableConcept | What stratifier component of the group
value |  | 1..1 | CodeableConcept | The stratum component value, e.g. male
population | S C | 0..* | BackboneElement | Population results in this stratum Constraints: deqm-9
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id for group.stratifier.population from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.population.linkId
extension:countQuantity | S C | 0..1 | Quantity | Size of the population as a quantity. URL: http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.).
count | S C | 1..1 | integer | Size of the population
measureScore | S | 0..1 | Quantity | What score this stratum achieved
Slices for extension |  |  |  | Content/Rules for all slices
extension:alternateScoreType | S | 0..1 | dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio | Possible additional measureScore value types URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MeasureReport.status | Base | required | MeasureReportStatus | 📦4.0.1 | FHIR Std.
MeasureReport.type | Base | required | MeasureReportType | 📍4.0.1 | FHIR Std.
MeasureReport.improvementNotation | Base | required | MeasureImprovementNotation | 📍4.0.1 | FHIR Std.
MeasureReport.group.​population.code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
MeasureReport.group.​measureScore.comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
MeasureReport.group.​stratifier.stratum.population.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
MeasureReport.group.​stratifier.stratum.measureScore.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
deqm-0 | error | MeasureReport.measure | Canonical URL SHALL contain a version. | `%resource.measure.toString().contains('|') and %resource.measure.substring(%resource.measure.toString().indexOf('|') + 1).length() > 0`
deqm-1 | error | MeasureReport.period | Date precision SHALL be at least to day ( YYYY-MM-DD ) | `start.toString().length()>9 and end.toString().length()>9`
deqm-2 | error | MeasureReport | If the measure scoring is specified at the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists().anyTrue() and extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable')).anyTrue() implies improvementNotation.exists()`
deqm-3 | error | MeasureReport | Measure scoring is required. It must be specified on the root only, or on every group, and it cannot be on both. | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists() and group.extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').empty()) xor (extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').empty() and group.all(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists()))`
deqm-4 | error | MeasureReport.group | If the measure scoring is specified on the group and the scoring type is 'proportion', 'ratio' or 'continuous-variable' then the groupImprovementNotation element is required. | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists().anyTrue() and extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable')).anyTrue() implies extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-groupImprovementNotation').exists()`
deqm-5 | error | MeasureReport | If the scoring, at either the root level or the group level, is other than composite then the group.population cardinality is >=1 | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains ('composite')).not().anyTrue() or (group.extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains ('composite')).not().anyTrue() implies group.population.count()>=1`
deqm-6 | error | MeasureReport.group | If the measure scoring type is 'proportion' then the measureScore SHALL be a numerical value between 0 and 1 | `((%resource.extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains 'proportion').anyTrue() or extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains 'proportion').anyTrue() implies (measureScore.value >= 0.0 and measureScore.value <= 1.0)`
deqm-7 | error | MeasureReport.group.stratifier | If group.stratifier exists, then either group.stratifier.code or the group.stratifier.stratum.component.code is present, but not both | `code.exists() xor stratum.component.exists()`
deqm-8 | error | MeasureReport.group.population | The population must either have a count (integer) or a countQuantity (quantity), but not both. | `extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists()`
deqm-9 | error | MeasureReport.group.stratifier.stratum.population | The stratum population must either have a count (integer) or a countQuantity (quantity), but not both. | `extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists()`
dom-2 | error | MeasureReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MeasureReport | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MeasureReport | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MeasureReport | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MeasureReport | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mrp-1 | error | MeasureReport | Measure Reports used for data collection SHALL NOT communicate group and score information | `(type != 'data-collection') or group.exists().not()`
mrp-2 | error | MeasureReport | Stratifiers SHALL be either a single criteria or a set of criteria components | `group.stratifier.stratum.all(value.exists() xor component.exists())`

Differential View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MeasureReport | C | 0..* | MeasureReport | Results of a measure evaluation Constraints: deqm-2, deqm-3, deqm-5
Slices for extension |  |  |  | Content/Rules for all slices
extension:reportingProgram |  | 0..1 | Identifier, canonical(CRMI Manifest Library) | Reporting program URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingProgram
extension:category | S | 0..1 | CodeableConcept | What category is this measure report URL: http://hl7.org/fhir/StructureDefinition/measurereport-category Binding: MeasureReportCategory (extensible)
extension:inputParameters |  | 0..1 | Reference(Parameters) | What parameters URL: http://hl7.org/fhir/StructureDefinition/cqf-inputParameters
extension:supplementalData | S | 0..* | (Complex) | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.supplementalData
value[x] |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
extension:description | S | 0..1 | markdown | Description of the supplemental data URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
extension:scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort | composite | attestation URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring Binding: Measure Scoring (extensible)
extension:vendor |  | 0..1 | Reference(Organization) | Vendor information URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingVendor
extension:location |  | 0..* | Reference(Location) | Location(s) from which reported data was gathered URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-dataLocation
extension:cehrt |  | 0..1 | (Complex) | CMS EHR Certification ID URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-certificationIdentifier
valueIdentifier |  | 1..1 | Identifier | Value of extension Required Pattern: At least the following
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: urn:oid:2.16.840.1.113883.3.2074.1
extension:software |  | 0..* | Reference(CRMI Software System Device) | Extension URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem
extension:message |  | 0..1 | Reference(OperationOutcome) | Evaluation messages URL: http://hl7.org/fhir/StructureDefinition/cqf-messages
extension:limitations | S | 0..1 | markdown | identifies what limitations should be noted, including potential selection biases and confounding factors when interpreting indicator results or comparing results across the country. If the extension is present in the Measure, then it SHALL be in the MeasureReport (MustSupport) and SHALL at least contain a copy of the content from the Measure. It is permissible to add content to the extensions in the MeasureReport. URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-limitations
extension:trendingIssues | S | 0..1 | markdown | 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). If the extension is present in the Measure, then it SHALL be in the MeasureReport (MustSupport) and SHALL at least contain a copy of the content from the Measure. It is permissible to add content to the extensions in the MeasureReport. URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-trendingIssues
status | S | 1..1 | code | complete | pending | error Binding: MeasureReportStatus (required)
type | S | 1..1 | code | individual | subject-list | summary | data-collection Fixed Value: summary
measure | S C | 1..1 | canonical(CRMI Shareable Measure) | What measure and version was calculated Constraints: deqm-0
subject |  | 0..1 | Reference(Group) | What group the report is for.
date | S | 1..1 | dateTime | When the report was generated. Note: The language in R5 was changed to calculated. We are clarifying that intent.
reporter | S | 1..1 | Reference(Organization | Practitioner | PractitionerRole) | Who is reporting the data. The reporter is the entity fulfilling the reporting requirement.
period | S C | 1..1 | Period | What period the report covers Constraints: deqm-1
start | S | 1..1 | dateTime | Starting time with inclusive boundary
end | S | 1..1 | dateTime | End time with inclusive boundary, if not ongoing
improvementNotation | S C | 0..1 | CodeableConcept | increase | decrease
group | S C | 1..* | BackboneElement | Measure results for each group Constraints: deqm-4, deqm-6
id | S | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  |  |  | Content/Rules for all slices
extension:linkId | S | 1..1 | string | Unique id of the group from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.linkId
extension:scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort | composite | attestation URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring Binding: Measure Scoring (extensible)
extension:cqm-compositeScoring | S | 0..1 | CodeableConcept | How the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
extension:calculatedDate | S | 0..1 | dateTime | The date the score was calculated URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-calculatedDate
extension:improvementNotation | S C | 0..1 | CodeableConcept | increase | decrease URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-groupImprovementNotation Binding: MeasureImprovementNotation (extensible)
extension:description | S | 0..1 | markdown | Description of the group URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
code | S | 0..1 | CodeableConcept | Meaning of the group
population | S C | 0..* | BackboneElement | The populations in the group Constraints: deqm-8
Slices for extension |  |  |  | Content/Rules for all slices
extension:linkId | S | 1..1 | string | Unique id for group.population from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.population.linkId
extension:countQuantity | S C | 0..1 | Quantity | Count as a Quantity URL: http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity
extension:description | S | 0..1 | markdown | Description of the population URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
count | S C | 0..1 | integer | Size of the population
subjectResults |  | 0..0 |  | For subject-list reports, the subject results in this population
measureScore | S C | 0..1 | Quantity | What score this group achieved
Slices for extension |  |  |  | Content/Rules for all slices
extension:alternateScoreType | S | 0..1 | dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio | Possible additional measureScore value types URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType
stratifier | S C | 0..* | BackboneElement | Stratification results Constraints: deqm-7
Slices for extension |  |  |  | Content/Rules for all slices
extension:linkId | S | 1..1 | string | Unique id for group.stratifier from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.linkId
extension:description | S | 0..1 | markdown | Description of the stratifier URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
code | S | 0..1 | CodeableConcept | What stratifier of the group
stratum | S | 0..* | BackboneElement | Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
value | S | 0..1 | CodeableConcept | The stratum value, e.g. male
component |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:linkId | S | 1..1 | string | Unique id for group.stratifier.component from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.component.linkId
population | S C | 0..* | BackboneElement | Population results in this stratum Constraints: deqm-9
Slices for extension |  |  |  | Content/Rules for all slices
extension:linkId | S | 1..1 | string | Unique id for group.stratifier.population from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.population.linkId
extension:countQuantity | S C | 0..1 | Quantity | Size of the population as a quantity. URL: http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
count | S C | 1..1 | integer | Size of the population
subjectResults |  | 0..0 |  | For subject-list reports, the subject results in this population
measureScore | S | 0..1 | Quantity | What score this stratum achieved
Slices for extension |  |  |  | Content/Rules for all slices
extension:alternateScoreType | S | 0..1 | dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio | Possible additional measureScore value types URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType
evaluatedResource |  | 0..0 |  | What data was used to calculate the measure score
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MeasureReport.status | Base | required | MeasureReportStatus | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
deqm-0 | error | MeasureReport.measure | Canonical URL SHALL contain a version. | `%resource.measure.toString().contains('|') and %resource.measure.substring(%resource.measure.toString().indexOf('|') + 1).length() > 0`
deqm-1 | error | MeasureReport.period | Date precision SHALL be at least to day ( YYYY-MM-DD ) | `start.toString().length()>9 and end.toString().length()>9`
deqm-2 | error | MeasureReport | If the measure scoring is specified at the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists().anyTrue() and extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable')).anyTrue() implies improvementNotation.exists()`
deqm-3 | error | MeasureReport | Measure scoring is required. It must be specified on the root only, or on every group, and it cannot be on both. | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists() and group.extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').empty()) xor (extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').empty() and group.all(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists()))`
deqm-4 | error | MeasureReport.group | If the measure scoring is specified on the group and the scoring type is 'proportion', 'ratio' or 'continuous-variable' then the groupImprovementNotation element is required. | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists().anyTrue() and extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable')).anyTrue() implies extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-groupImprovementNotation').exists()`
deqm-5 | error | MeasureReport | If the scoring, at either the root level or the group level, is other than composite then the group.population cardinality is >=1 | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains ('composite')).not().anyTrue() or (group.extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains ('composite')).not().anyTrue() implies group.population.count()>=1`
deqm-6 | error | MeasureReport.group | If the measure scoring type is 'proportion' then the measureScore SHALL be a numerical value between 0 and 1 | `((%resource.extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains 'proportion').anyTrue() or extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains 'proportion').anyTrue() implies (measureScore.value >= 0.0 and measureScore.value <= 1.0)`
deqm-7 | error | MeasureReport.group.stratifier | If group.stratifier exists, then either group.stratifier.code or the group.stratifier.stratum.component.code is present, but not both | `code.exists() xor stratum.component.exists()`
deqm-8 | error | MeasureReport.group.population | The population must either have a count (integer) or a countQuantity (quantity), but not both. | `extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists()`
deqm-9 | error | MeasureReport.group.stratifier.stratum.population | The stratum population must either have a count (integer) or a countQuantity (quantity), but not both. | `extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists()`

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MeasureReport | C | 0..* | MeasureReport | Results of a measure evaluation Constraints: mrp-1, mrp-2, deqm-2, deqm-3, deqm-5
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:reportingProgram |  | 0..1 | Identifier, canonical(CRMI Manifest Library) | Reporting program URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingProgram
extension:category | S | 0..1 | CodeableConcept | What category is this measure report URL: http://hl7.org/fhir/StructureDefinition/measurereport-category Binding: MeasureReportCategory (extensible)
extension:inputParameters |  | 0..1 | Reference(Parameters) | What parameters URL: http://hl7.org/fhir/StructureDefinition/cqf-inputParameters
extension:supplementalData | S | 0..* | (Complex) | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.supplementalData
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.supplementalData"
value[x] |  | 1..1 | Reference(Resource) | Value of extension
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:criteriaReference | S | 0..1 | string | Criteria reference URL: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
extension:description | S | 0..1 | markdown | Description of the supplemental data URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
extension:scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort | composite | attestation URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring Binding: Measure Scoring (extensible)
extension:vendor |  | 0..1 | Reference(Organization) | Vendor information URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingVendor
extension:location |  | 0..* | Reference(Location) | Location(s) from which reported data was gathered URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-dataLocation
extension:cehrt |  | 0..1 | (Complex) | CMS EHR Certification ID URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-certificationIdentifier
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 | "http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-certificationIdentifier"
Slices for value[x] |  | 1..1 | Identifier | Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueIdentifier |  | 1..1 | Identifier | Value of extension Required Pattern: At least the following
extension:software |  | 0..* | Reference(CRMI Software System Device) | Extension URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem
extension:message |  | 0..1 | Reference(OperationOutcome) | Evaluation messages URL: http://hl7.org/fhir/StructureDefinition/cqf-messages
extension:limitations | S | 0..1 | markdown | identifies what limitations should be noted, including potential selection biases and confounding factors when interpreting indicator results or comparing results across the country. If the extension is present in the Measure, then it SHALL be in the MeasureReport (MustSupport) and SHALL at least contain a copy of the content from the Measure. It is permissible to add content to the extensions in the MeasureReport. URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-limitations
extension:trendingIssues | S | 0..1 | markdown | 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). If the extension is present in the Measure, then it SHALL be in the MeasureReport (MustSupport) and SHALL at least contain a copy of the content from the Measure. It is permissible to add content to the extensions in the MeasureReport. URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-trendingIssues
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Additional identifier for the MeasureReport
status | ?!S Σ | 1..1 | code | complete | pending | error Binding: MeasureReportStatus (required)
type | S Σ C | 1..1 | code | individual | subject-list | summary | data-collection Binding: MeasureReportType (required): The type of the measure report. Fixed Value: summary
measure | S Σ C | 1..1 | canonical(CRMI Shareable Measure) | What measure and version was calculated Constraints: deqm-0
subject | Σ | 0..1 | Reference(Group) | What group the report is for.
date | S Σ | 1..1 | dateTime | When the report was generated. Note: The language in R5 was changed to calculated. We are clarifying that intent.
reporter | S Σ | 1..1 | Reference(Organization | Practitioner | PractitionerRole) | Who is reporting the data. The reporter is the entity fulfilling the reporting requirement.
period | S Σ C | 1..1 | Period | What period the report covers Constraints: deqm-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
start | S Σ C | 1..1 | dateTime | Starting time with inclusive boundary
end | S Σ C | 1..1 | dateTime | End time with inclusive boundary, if not ongoing
improvementNotation | ?!S Σ C | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.
group | S C | 1..* | BackboneElement | Measure results for each group Constraints: deqm-4, deqm-6
id | S | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id of the group from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.linkId
extension:scoring | S C | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort | composite | attestation URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring Binding: Measure Scoring (extensible)
extension:cqm-compositeScoring | S | 0..1 | CodeableConcept | How the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
extension:calculatedDate | S | 0..1 | dateTime | The date the score was calculated URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-calculatedDate
extension:improvementNotation | S C | 0..1 | CodeableConcept | increase | decrease URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-groupImprovementNotation Binding: MeasureImprovementNotation (extensible)
extension:description | S | 0..1 | markdown | Description of the group URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 0..1 | CodeableConcept | Meaning of the group
population | S C | 0..* | BackboneElement | The populations in the group Constraints: deqm-8
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id for group.population from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.population.linkId
extension:countQuantity | S C | 0..1 | Quantity | Count as a Quantity URL: http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity
extension:description | S | 0..1 | markdown | Description of the population URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.).
count | S C | 0..1 | integer | Size of the population
measureScore | S Σ C | 0..1 | Quantity | What score this group achieved
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:alternateScoreType | S | 0..1 | dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio | Possible additional measureScore value types URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType
value | Σ | 0..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | Σ | 0..1 | string | Unit representation
system | Σ C | 0..1 | uri | System that defines coded unit form
code | Σ | 0..1 | code | Coded form of the unit
stratifier | S C | 0..* | BackboneElement | Stratification results Constraints: deqm-7
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id for group.stratifier from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.linkId
extension:description | S | 0..1 | markdown | Description of the stratifier URL: http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 0..1 | CodeableConcept | What stratifier of the group
stratum | S | 0..* | BackboneElement | Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
value | S | 0..1 | CodeableConcept | The stratum value, e.g. male
component |  | 0..* | BackboneElement | Stratifier component values
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id for group.stratifier.component from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.component.linkId
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 1..1 | CodeableConcept | What stratifier component of the group
value |  | 1..1 | CodeableConcept | The stratum component value, e.g. male
population | S C | 0..* | BackboneElement | Population results in this stratum Constraints: deqm-9
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:linkId | S | 1..1 | string | Unique id for group.stratifier.population from the measure. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.population.linkId
extension:countQuantity | S C | 0..1 | Quantity | Size of the population as a quantity. URL: http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S | 1..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.).
count | S C | 1..1 | integer | Size of the population
measureScore | S | 0..1 | Quantity | What score this stratum achieved
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:alternateScoreType | S | 0..1 | dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio | Possible additional measureScore value types URL: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType
value | Σ | 0..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | Σ | 0..1 | string | Unit representation
system | Σ C | 0..1 | uri | System that defines coded unit form
code | Σ | 0..1 | code | Coded form of the unit
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MeasureReport.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MeasureReport.extension:supplementalData.​value[x].type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
MeasureReport.status | Base | required | MeasureReportStatus | 📦4.0.1 | FHIR Std.
MeasureReport.type | Base | required | MeasureReportType | 📍4.0.1 | FHIR Std.
MeasureReport.improvementNotation | Base | required | MeasureImprovementNotation | 📍4.0.1 | FHIR Std.
MeasureReport.group.​population.code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
MeasureReport.group.​measureScore.comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
MeasureReport.group.​stratifier.stratum.population.​code | Base | extensible | MeasurePopulationType | 📍4.0.1 | FHIR Std.
MeasureReport.group.​stratifier.stratum.measureScore.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
deqm-0 | error | MeasureReport.measure | Canonical URL SHALL contain a version. | `%resource.measure.toString().contains('|') and %resource.measure.substring(%resource.measure.toString().indexOf('|') + 1).length() > 0`
deqm-1 | error | MeasureReport.period | Date precision SHALL be at least to day ( YYYY-MM-DD ) | `start.toString().length()>9 and end.toString().length()>9`
deqm-2 | error | MeasureReport | If the measure scoring is specified at the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists().anyTrue() and extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable')).anyTrue() implies improvementNotation.exists()`
deqm-3 | error | MeasureReport | Measure scoring is required. It must be specified on the root only, or on every group, and it cannot be on both. | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists() and group.extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').empty()) xor (extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').empty() and group.all(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists()))`
deqm-4 | error | MeasureReport.group | If the measure scoring is specified on the group and the scoring type is 'proportion', 'ratio' or 'continuous-variable' then the groupImprovementNotation element is required. | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').exists().anyTrue() and extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable')).anyTrue() implies extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-groupImprovementNotation').exists()`
deqm-5 | error | MeasureReport | If the scoring, at either the root level or the group level, is other than composite then the group.population cardinality is >=1 | `(extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains ('composite')).not().anyTrue() or (group.extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains ('composite')).not().anyTrue() implies group.population.count()>=1`
deqm-6 | error | MeasureReport.group | If the measure scoring type is 'proportion' then the measureScore SHALL be a numerical value between 0 and 1 | `((%resource.extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains 'proportion').anyTrue() or extension('http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring').value.coding.code contains 'proportion').anyTrue() implies (measureScore.value >= 0.0 and measureScore.value <= 1.0)`
deqm-7 | error | MeasureReport.group.stratifier | If group.stratifier exists, then either group.stratifier.code or the group.stratifier.stratum.component.code is present, but not both | `code.exists() xor stratum.component.exists()`
deqm-8 | error | MeasureReport.group.population | The population must either have a count (integer) or a countQuantity (quantity), but not both. | `extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists()`
deqm-9 | error | MeasureReport.group.stratifier.stratum.population | The stratum population must either have a count (integer) or a countQuantity (quantity), but not both. | `extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists()`
dom-2 | error | MeasureReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MeasureReport | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MeasureReport | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MeasureReport | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MeasureReport | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mrp-1 | error | MeasureReport | Measure Reports used for data collection SHALL NOT communicate group and score information | `(type != 'data-collection') or group.exists().not()`
mrp-2 | error | MeasureReport | Stratifiers SHALL be either a single criteria or a set of criteria components | `group.stratifier.stratum.all(value.exists() xor component.exists())`

Summary

Mandatory: 7 elements(8 nested mandatory elements)
Must-Support: 47 elements
Fixed: 1 element
Prohibited: 3 elements

Structures

This structure refers to these other structures:

- CRMI Shareable Measure (http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingProgram
- http://hl7.org/fhir/StructureDefinition/measurereport-category
- http://hl7.org/fhir/StructureDefinition/cqf-inputParameters
- http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.supplementalData
- http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
- http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription
- http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring
- http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingVendor
- http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-dataLocation
- http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-certificationIdentifier
- http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem
- http://hl7.org/fhir/StructureDefinition/cqf-messages
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-limitations
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-trendingIssues
- http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.linkId
- http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring
- http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-calculatedDate
- http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-groupImprovementNotation
- http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.population.linkId
- http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity
- http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType
- http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.linkId
- http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.component.linkId
- http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.population.linkId

Maturity: 4

Other representations of profile: CSV, Excel, Schematron

### Notes:

This profile is used in the following transactions:

Summary Measure Reporting Interactions