Data Exchange For Quality Measures Implementation Guide
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## : Summ Medicare Stratification Example

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    {
      "resourceType" : "MeasureReport",
      "id" : "summ-medicare-stratification-example",
      "meta" : {
        "source" : "http://example.org/fhir/server",
        "profile" : [
          🔗 "http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-summarymeasurereport"
        ]
      },
      "language" : "en",
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p class=\"res-header-id\"><b>Generated Narrative: MeasureReport summ-medicare-stratification-example</b></p><a name=\"summ-medicare-stratification-example\"> </a><a name=\"hcsumm-medicare-stratification-example\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Language: en; </p><p style=\"margin-bottom: 0px\">Information Source: <a href=\"http://example.org/fhir/server\">http://example.org/fhir/server</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-deqm-summarymeasurereport.html\">DEQM Summary MeasureReport Profile</a></p></div><p><b>DEQM Measure Scoring Extension</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-scoring proportion}\">Proportion</span></p><p><b>status</b>: Complete</p><p><b>type</b>: Summary</p><p><b>measure</b>: <a href=\"http://hl7.org/fhir/uv/cqm/2026May/Measure-EXM55-FHIR.html\">EXM55 - Median Emergency Department Visit Duration</a> version: 5.0.0</p><p><b>date</b>: 2018-09-05 16:59:52+0000</p><p><b>reporter</b>: <a href=\"Organization-organization01.html\">Organization DaVinciHospital01</a></p><p><b>period</b>: 2018-01-01 --&gt; 2018-12-31</p><p><b>improvementNotation</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-improvement-notation increase}\">Increased score indicates improvement</span></p><blockquote><p><b>group</b></p><p><b>Extension Definition for MeasureReport.group.linkId for Version 5.0</b>: group-1</p><blockquote><p><b>population</b></p><p><b>Extension Definition for MeasureReport.group.population.linkId for Version 5.0</b>: initial-population</p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-population initial-population}\">Initial Population</span></p><p><b>count</b>: 10000</p></blockquote><blockquote><p><b>population</b></p><p><b>Extension Definition for MeasureReport.group.population.linkId for Version 5.0</b>: measure-population</p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-population measure-population}\">Measure Population</span></p><p><b>count</b>: 8000</p></blockquote><blockquote><p><b>population</b></p><p><b>Extension Definition for MeasureReport.group.population.linkId for Version 5.0</b>: measure-population-exclusion</p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-population measure-population-exclusion}\">Measure Population Exclusion</span></p><p><b>count</b>: 4000</p></blockquote><p><b>measureScore</b>: 0.5</p><blockquote><p><b>stratifier</b></p><p><b>Extension Definition for MeasureReport.group.stratifier.linkId for Version 5.0</b>: Stratification 1</p><p><b>code</b>: <span title=\"Codes:{http://example.org/stratification Stratification 1}\">Stratification 1</span></p><blockquote><p><b>stratum</b></p><p><b>value</b>: <span title=\"Codes:{http://example.org/stratification true}\">true</span></p><blockquote><p><b>population</b></p><p><b>Extension Definition for MeasureReport.group.stratifier.stratum.population.linkId for Version 5.0</b>: initial-population</p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-population initial-population}\">Initial Population</span></p><p><b>count</b>: 1747</p></blockquote><blockquote><p><b>population</b></p><p><b>Extension Definition for MeasureReport.group.stratifier.stratum.population.linkId for Version 5.0</b>: denominator</p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-population denominator}\">Denominator</span></p><p><b>count</b>: 392</p></blockquote><blockquote><p><b>population</b></p><p><b>Extension Definition for MeasureReport.group.stratifier.stratum.population.linkId for Version 5.0</b>: numerator</p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-population numerator}\">Numerator</span></p><p><b>count</b>: 243</p></blockquote><p><b>measureScore</b>: 0.699</p></blockquote></blockquote><blockquote><p><b>stratifier</b></p><blockquote><p><b>id</b></p>Stratification 2</blockquote><p><b>Extension Definition for MeasureReport.group.stratifier.linkId for Version 5.0</b>: Stratification 2</p><p><b>code</b>: <span title=\"Codes:{http://example.org/stratification Stratification 2}\">Stratification 2</span></p><blockquote><p><b>stratum</b></p><p><b>value</b>: <span title=\"Codes:{http://example.org/CodeSystem/SOP MEDICARE}\">Medicare</span></p><blockquote><p><b>population</b></p><p><b>Extension Definition for MeasureReport.group.stratifier.stratum.population.linkId for Version 5.0</b>: initial-population</p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-population initial-population}\">Initial Population</span></p><p><b>count</b>: 745</p></blockquote><blockquote><p><b>population</b></p><p><b>Extension Definition for MeasureReport.group.stratifier.stratum.population.linkId for Version 5.0</b>: denominator</p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-population denominator}\">Denominator</span></p><p><b>count</b>: 150</p></blockquote><blockquote><p><b>population</b></p><p><b>Extension Definition for MeasureReport.group.stratifier.stratum.population.linkId for Version 5.0</b>: numerator</p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-population numerator}\">Numerator</span></p><p><b>count</b>: 103</p></blockquote><p><b>measureScore</b>: 0.6867</p></blockquote></blockquote><blockquote><p><b>stratifier</b></p><blockquote><p><b>id</b></p>Stratification 3</blockquote><p><b>Extension Definition for MeasureReport.group.stratifier.linkId for Version 5.0</b>: Stratification 3</p><p><b>code</b>: <span title=\"Codes:{http://example.org/stratification Stratification 3}\">Stratification 3</span></p><h3>Strata</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://example.org/CodeSystem/medicare-subgroup Non-LIS/DE,Nondisability}\">Non-LIS/DE,Nondisability</span></td></tr></table></blockquote></blockquote></div>"
      },
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
                "code" : "proportion"
              }
            ]
          }
        }
      ],
      "status" : "complete",
      "type" : "summary",
      "measure" : "http://hl7.org/fhir/uv/cqm/Measure/EXM55-FHIR|5.0.0",
      "date" : "2018-09-05T16:59:52.404Z",
      "reporter" : {
        🔗 "reference" : "Organization/organization01"
      },
      "period" : {
        "start" : "2018-01-01",
        "end" : "2018-12-31"
      },
      "improvementNotation" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
            "code" : "increase",
            "display" : "Increased score indicates improvement"
          }
        ]
      },
      "group" : [
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.linkId",
              "valueString" : "group-1"
            }
          ],
          "population" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.population.linkId",
                  "valueString" : "initial-population"
                }
              ],
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "initial-population"
                  }
                ]
              },
              "count" : 10000
            },
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.population.linkId",
                  "valueString" : "measure-population"
                }
              ],
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "measure-population"
                  }
                ]
              },
              "count" : 8000
            },
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.population.linkId",
                  "valueString" : "measure-population-exclusion"
                }
              ],
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "measure-population-exclusion"
                  }
                ]
              },
              "count" : 4000
            }
          ],
          "measureScore" : {
            "value" : 0.5
          },
          "stratifier" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.linkId",
                  "valueString" : "Stratification 1"
                }
              ],
              "code" : [
                {
                  "coding" : [
                    {
                      "system" : "http://example.org/stratification",
                      "code" : "Stratification 1",
                      "display" : "Stratification 1"
                    }
                  ]
                }
              ],
              "stratum" : [
                {
                  "value" : {
                    "coding" : [
                      {
                        "system" : "http://example.org/stratification",
                        "code" : "true"
                      }
                    ]
                  },
                  "population" : [
                    {
                      "extension" : [
                        {
                          "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.population.linkId",
                          "valueString" : "initial-population"
                        }
                      ],
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                            "code" : "initial-population"
                          }
                        ]
                      },
                      "count" : 1747
                    },
                    {
                      "extension" : [
                        {
                          "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.population.linkId",
                          "valueString" : "denominator"
                        }
                      ],
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                            "code" : "denominator"
                          }
                        ]
                      },
                      "count" : 392
                    },
                    {
                      "extension" : [
                        {
                          "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.population.linkId",
                          "valueString" : "numerator"
                        }
                      ],
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                            "code" : "numerator"
                          }
                        ]
                      },
                      "count" : 243
                    }
                  ],
                  "measureScore" : {
                    "value" : 0.699
                  }
                }
              ]
            },
            {
              "id" : "Stratification 2",
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.linkId",
                  "valueString" : "Stratification 2"
                }
              ],
              "code" : [
                {
                  "coding" : [
                    {
                      "system" : "http://example.org/stratification",
                      "code" : "Stratification 2",
                      "display" : "Stratification 2"
                    }
                  ]
                }
              ],
              "stratum" : [
                {
                  "value" : {
                    "coding" : [
                      {
                        "system" : "http://example.org/CodeSystem/SOP",
                        "code" : "MEDICARE",
                        "display" : "Medicare"
                      }
                    ]
                  },
                  "population" : [
                    {
                      "extension" : [
                        {
                          "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.population.linkId",
                          "valueString" : "initial-population"
                        }
                      ],
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                            "code" : "initial-population"
                          }
                        ]
                      },
                      "count" : 745
                    },
                    {
                      "extension" : [
                        {
                          "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.population.linkId",
                          "valueString" : "denominator"
                        }
                      ],
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                            "code" : "denominator"
                          }
                        ]
                      },
                      "count" : 150
                    },
                    {
                      "extension" : [
                        {
                          "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.population.linkId",
                          "valueString" : "numerator"
                        }
                      ],
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                            "code" : "numerator"
                          }
                        ]
                      },
                      "count" : 103
                    }
                  ],
                  "measureScore" : {
                    "value" : 0.6867
                  }
                }
              ]
            },
            {
              "id" : "Stratification 3",
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.linkId",
                  "valueString" : "Stratification 3"
                }
              ],
              "code" : [
                {
                  "coding" : [
                    {
                      "system" : "http://example.org/stratification",
                      "code" : "Stratification 3",
                      "display" : "Stratification 3"
                    }
                  ]
                }
              ],
              "stratum" : [
                {
                  "value" : {
                    "coding" : [
                      {
                        "system" : "http://example.org/CodeSystem/medicare-subgroup",
                        "code" : "Non-LIS/DE,Nondisability",
                        "display" : "Non-LIS/DE,Nondisability"
                      }
                    ]
                  }
                }
              ]
            }
          ]
        }
      ]
    }