Data Exchange For Quality Measures Implementation Guide
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## Resource Profile: DEQM Individual MeasureReport Profile - Detailed Descriptions

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

Definitions for the deqm-individualmeasurereport resource profile

- Key Elements Table
- Differential Table
- Snapshot Table

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

0. MeasureReport
Definition | The MeasureReport resource contains the results of the calculation of a measure; and optionally a reference to the resources involved in that calculation.
Short | Results of a measure evaluation
Control | 0..*
Is Modifier | false
Must Support | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information (`(type != 'data-collection') or group.exists().not()`) mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components (`group.stratifier.stratum.all(value.exists() xor component.exists())`) deqm-2: 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: 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-5: 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`) mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information ((type != 'data-collection') or group.exists().not()) mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components (group.stratifier.stratum.all(value.exists() xor component.exists()))
2. MeasureReport.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. MeasureReport.extension:careGapRemark
Slice Name | careGapRemark
Definition | Remark about a Condition Category.
Short | Condition Category remark
Control | 0..* This element is affected by the following invariants: ele-1, cgr-1
Type | Extension(DEQM Care Gap Remark Extension) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) cgr-1: A remark shall include an author, an authorOrganization, or an authorSoftware (`extension.where(url = 'author').exists() or extension.where(url = 'authorOrganization').exists() or extension.where(url = 'authorSoftware').exists()`)
6. MeasureReport.extension:message
Slice Name | message
Definition | An OperationOutcome resource with information, warning, or error messages that were generated as part of processing an operation.
Short | Evaluation messages
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Messages) (Extension Type: Reference(OperationOutcome))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. MeasureReport.extension:category
Slice Name | category
Definition | Specifies the category of a measure report.
Short | What category is this measure report
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Measure Report Category) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. MeasureReport.extension:reportingProgram
Slice Name | reportingProgram
Definition | Reference the reporting program by referencing their unique id specified in a Library resource that conforms to the Quality Program profile.
Short | Reporting program
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(DEQM Reporting Program Extension) (Extension Type: Choice of: Identifier, canonical(CRMI Manifest Library))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. MeasureReport.extension:inputParameters
Slice Name | inputParameters
Definition | Specifies the input parameters to the operation (such as a test case description or a data requirements or evaluate operation). This extension can be used as part of the result of an operation to indicate what the parameters were, but it can also be used as part of the definition of a test case to specify what the input parameters are expected to be for the test case.
Short | What parameters
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Input parameters) (Extension Type: Reference(Parameters))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. MeasureReport.extension:supplementalData
Slice Name | supplementalData
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for MeasureReport.supplementalData for Version 5.0) (Extension Type: Reference(Resource))
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
16. MeasureReport.extension:supplementalData.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `MeasureReport.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
18. MeasureReport.extension:supplementalData.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.supplementalData`
20. MeasureReport.extension:supplementalData.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 10..1
Type | Reference(Resource), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. MeasureReport.extension:supplementalData.value[x].extension:criteriaReference
Slice Name | criteriaReference
Definition | Reference a criteria by specifying that criteria's unique id
Short | Criteria reference
Comments | When used in a MeasureReport, this is a reference to the id of a criteria within the Measure referenced by the MeasureReport.
Control | 0..1
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
24. MeasureReport.extension:supplementalData.value[x].extension:description
Slice Name | description
Definition | A description of the group, population, stratifier, or supplemental data definition on which it appears. This is typically a restatement of the description of the corresponding element in the Measure being reported, but may also include additional information gathered by the reporting process.
Short | Description of the supplemental data
Control | 0..1
Type | Extension(Measure Report Population Description) (Extension Type: markdown)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
26. MeasureReport.extension:scoring
Slice Name | scoring
Definition | Optional Extension Element - found in all resources.
Short | proportion | ratio | continuous-variable | cohort | composite | attestation
Control | 0..1 This element is affected by the following invariants: ele-1, deqm-2, deqm-3, deqm-6
Type | Extension(DEQM Measure Scoring Extension) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
28. MeasureReport.extension:vendor
Slice Name | vendor
Definition | A reference to the vendor who queried the data, calculated results and/or generated the report.
Short | Vendor information
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(DEQM Reporting Vendor Extension) (Extension Type: Reference(Organization))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
30. MeasureReport.extension:cehrt
Slice Name | cehrt
Definition | An identifier that represents the EHR certication number (CERHT). See Certified EHR Technology For more information.
Short | CMS EHR Certification ID
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(DEQM Certification Identifier Extension) (Extension Type: Identifier)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
32. MeasureReport.extension:cehrt.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-certificationIdentifier`
34. MeasureReport.extension:cehrt.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 10..1
Type | Identifier, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `MeasureReport.extension.value[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
36. MeasureReport.extension:cehrt.value[x]:valueIdentifier
Slice Name | valueIdentifier
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 10..1
Type | Identifier, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Pattern Value | `{ "system" : "urn:oid:2.16.840.1.113883.3.2074.1" }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. MeasureReport.extension:software
Slice Name | software
Definition | Specifies the software systems used in the packaging and testing of knowledge artifacts. Specifically to support explicitly stating which versions of the various software components were used in the authoring, packaging, and testing.
Short | Extension
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(CRMI Software System) (Extension Type: Reference(CRMI Software System Device))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
40. MeasureReport.extension:location
Slice Name | location
Definition | Location from which reported data was gathered. This extension is used to provide the location(s) from which reported data was gathered in a MeasureReport, such as individual, summary and data exchange measure report.
Short | Location(s) from which reported data was gathered
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(DEQM Data Location Extension) (Extension Type: Reference(Location))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
42. MeasureReport.extension:limitations
Slice Name | limitations
Definition | identifies what limitations should be noted, including potential selection biases and confounding factors when interpreting indicator results or comparing results across the country.
Short | 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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Limitations) (Extension Type: markdown)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
44. MeasureReport.extension:trendingIssues
Slice Name | trendingIssues
Definition | identifies what issues might affect the interpretation of trending results, including changes in geographic coverage, data quality, coding standards and classification changes (for example, a new ICD standard).
Short | 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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Trending Issues) (Extension Type: markdown)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
46. MeasureReport.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
48. MeasureReport.status
Definition | The MeasureReport status. No data will be available until the MeasureReport status is complete.
Short | complete | pending | error
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from MeasureReportStatus http://hl7.org/fhir/ValueSet/measure-report-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/measure-report-status|4.0.1` ) The status of the measure report.
Type | code
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. MeasureReport.type
Definition | The type of measure report. This may be an individual report, which provides the score for the measure for an individual member of the population; a subject-listing, which returns the list of members that meet the various criteria in the measure; a summary report, which returns a population count for each of the criteria in the measure; or a data-collection, which enables the MeasureReport to be used to exchange the data-of-interest for a quality measure.
Short | individual | subject-list | summary | data-collection
Comments | Data-collection reports are used only to communicate data-of-interest for a measure. They do not necessarily include all the data for a particular subject or population, but they may.
Control | 1..1 This element is affected by the following invariants: mrp-1
Binding | The codes SHALL be taken from MeasureReportType http://hl7.org/fhir/ValueSet/measure-report-type|4.0.1 (required to `http://hl7.org/fhir/ValueSet/measure-report-type|4.0.1` ) The type of the measure report.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | For individual quality meaure reporting, this report is constrained to reporting on an individual.
Fixed Value | `individual`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. MeasureReport.measure
Definition | A reference to the Measure that was calculated to produce this report.
Short | What measure was calculated
Control | 1..1 This element is affected by the following invariants: deqm-0
Type | canonical(CRMI Shareable Measure, Measure)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | This will indicate the measure and version being reported on. For example, the cannonical uri location for the MRP measure.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) deqm-0: Canonical URL SHALL contain a version. (`%resource.measure.toString().contains('|') and %resource.measure.substring(%resource.measure.toString().indexOf('|') + 1).length() > 0`)
54. MeasureReport.subject
Definition | Optional subject identifying the individual or individuals the report is for.
Short | What individual(s) the report is for
Control | 10..1
Type | Reference(Patient, Practitioner, PractitionerRole, Location, Device, RelatedPerson, Patient, Practitioner, PractitionerRole, Location, Device, RelatedPerson, Group)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. MeasureReport.date
Definition | The date this measure report was generated.
Short | When the report was generated. Note: The language in R5 was changed to calculated. We are clarifying that intent.
Control | 10..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. MeasureReport.reporter
Definition | Who is reporting the data. The reporter is the entity fulfilling the reporting requirement. The individual, location, or organization that is reporting the data.
Short | Who is reporting the data. The reporter is the entity fulfilling the reporting requirement.
Control | 10..1
Type | Reference(Organization, Practitioner, PractitionerRole, Practitioner, PractitionerRole, Location, Organization)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. MeasureReport.period
Definition | The reporting period for which the report was calculated.
Short | The period for which the report was calculated. For the gaps in care use case, this is referred to as the gaps through period.What period the report covers
Control | 1..1 This element is affected by the following invariants: deqm-1
Type | Period
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) deqm-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) (`start.toString().length()>9 and end.toString().length()>9`)
62. MeasureReport.period.start
Definition | The start of the period. The boundary is inclusive.
Short | Starting time with inclusive boundary
Comments | If the low element is missing, the meaning is that the low boundary is not known.
Control | 10..1 This element is affected by the following invariants: per-1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. MeasureReport.period.end
Definition | The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Short | End time with inclusive boundary, if not ongoing
Comments | The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
Control | 10..1 This element is affected by the following invariants: per-1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Meaning if Missing | If the end of the period is missing, it means that the period is ongoing
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. MeasureReport.improvementNotation
Definition | Whether improvement in the measure is noted by an increase or decrease in the measure score.
Short | increase | decrease
Comments | This element is typically defined by the measure, but reproduced here to ensure the measure score can be interpreted. The element is labeled as a modifier because it changes the interpretation of the reported measure score.
Control | 0..1 This element is affected by the following invariants: deqm-2
Binding | The codes SHALL be taken from MeasureImprovementNotation http://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.1 (required to `http://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.1` ) Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.
Type | CodeableConcept
Is Modifier | true because Improvement notation determines how to interpret the measure score (i.e. whether an increase is an improvement)
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. MeasureReport.group
Definition | The results of the calculation, one for each population group in the measure.
Short | Measure results for each group
Control | 0..* This element is affected by the following invariants: mrp-1
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) deqm-4: 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-6: 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)`)
70. MeasureReport.group.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
Must Support | true
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
72. MeasureReport.group.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `MeasureReport.group.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
74. MeasureReport.group.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the group from the measure.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for MeasureReport.group.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
76. MeasureReport.group.extension:scoring
Slice Name | scoring
Definition | Optional Extension Element - found in all resources.
Short | proportion | ratio | continuous-variable | cohort | composite | attestation
Control | 0..1 This element is affected by the following invariants: ele-1, deqm-3
Type | Extension(DEQM Measure Scoring Extension) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
78. MeasureReport.group.extension:cqm-compositeScoring
Slice Name | cqm-compositeScoring
Definition | Indicates how the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort. The value set is extensible, allowing additional measure scoring types to be represented. When present on a group, specifies the scoring to be used for this group, overriding the scoring specified for the overall measure.
Short | How the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Composite Scoring) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
80. MeasureReport.group.extension:calculatedDate
Slice Name | calculatedDate
Definition | This applies to the date this metric was actually calculated. If your measure calculation draws on stored calculations and there are multiple calculation dates, this extension would not apply, as in the example of a composite measure where the individual measures were calculated on different dates. This would only cover the case where there is only one calculation date.
Short | The date the score was calculated
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(DEQM Calculated Date Extension) (Extension Type: dateTime)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
82. MeasureReport.group.extension:improvementNotation
Slice Name | improvementNotation
Definition | An Extension
Short | increase | decrease
Control | 0..1 This element is affected by the following invariants: ele-1, deqm-4
Type | Extension(DEQM Group Improvement Notation Extension) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
84. MeasureReport.group.extension:description
Slice Name | description
Definition | A description of the group, population, stratifier, or supplemental data definition on which it appears. This is typically a restatement of the description of the corresponding element in the Measure being reported, but may also include additional information gathered by the reporting process.
Short | Description of the group
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Measure Report Population Description) (Extension Type: markdown)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
86. MeasureReport.group.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
88. MeasureReport.group.code
Definition | The meaning of the population group as defined in the measure definition.
Short | Meaning of the group
Control | 0..1
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
90. MeasureReport.group.population
Definition | The populations that make up the population group, one for each type of population appropriate for the measure.
Short | The populations in the group
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) deqm-8: 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()`)
92. MeasureReport.group.population.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `MeasureReport.group.population.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
94. MeasureReport.group.population.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id for group.population from the measure.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for MeasureReport.group.population.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
96. MeasureReport.group.population.extension:countQuantity
Slice Name | countQuantity
Definition | The count of the population represented as a Quantity. This is used in cases where the count may be a decimal value such as in a ratio measure.
Short | Count as a Quantity
Control | 0..1 This element is affected by the following invariants: ele-1, deqm-8
Type | Extension(Count Quantity) (Extension Type: Quantity)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
98. MeasureReport.group.population.extension:description
Slice Name | description
Definition | A description of the group, population, stratifier, or supplemental data definition on which it appears. This is typically a restatement of the description of the corresponding element in the Measure being reported, but may also include additional information gathered by the reporting process.
Short | Description of the population
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Measure Report Population Description) (Extension Type: markdown)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
100. MeasureReport.group.population.extension:supportingEvidence
Slice Name | supportingEvidence
Definition | An Extension
Short | Specifies the result of a supporting evidence expression in the measure population.
Control | 0..*
Type | Extension(`http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidence`)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
102. MeasureReport.group.population.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
104. MeasureReport.group.population.code
Definition | The type of the population.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType http://hl7.org/fhir/ValueSet/measure-population|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/measure-population|4.0.1` ) The type of population (e.g. initial, numerator, denominator, etc.).
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
106. MeasureReport.group.population.count
Definition | The number of members of the population.
Short | Size of the population
Control | 0..1 This element is affected by the following invariants: deqm-8
Type | integer
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
108. MeasureReport.group.population.subjectResults
Definition | This element refers to a List of subject level MeasureReport resources, one for each subject in this population.
Short | For subject-list reports, the subject results in this population
Control | 0..01
Type | Reference(List)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
110. MeasureReport.group.measureScore
Definition | The measure score for this population group, calculated as appropriate for the measure type and scoring method, and based on the contents of the populations defined in the group.
Short | What score this group achieved
Comments | For individual reporting, the measure score is calculated for the individual. For a proportion measure, it would be 0.0 or 1.0 (indicating 0% or 100%).
Control | 0..1 This element is affected by the following invariants: deqm-6
Type | Quantity
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
112. MeasureReport.group.measureScore.extension:alternateScoreType
Slice Name | alternateScoreType
Definition | Possible value types for the measureScore elements in addition to the standard Quantity type. The alternate type is determined by the Quality Measure Aggregate Method extension used on the Measure. The reported type of the measureScore for continuous variable measures is determined by the result type of the aggregate method operation.
Short | Possible additional measureScore value types
Comments | This extension corresponds to the additional MeasureScore type added to the R5 version of MeasureReport.
Control | 0..1
Type | Extension(DEQM Alternate Score Type Extension) (Extension Type: Choice of: dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
114. MeasureReport.group.measureScore.comparator
Definition | How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Short | < | <= | >= | > - how to understand the value
Control | 0..1
Binding | The codes SHALL be taken from QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 (required to `http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1` ) How the Quantity should be understood and represented.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning if Missing | If there is no comparator, then there is no modification of the value
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
116. MeasureReport.group.stratifier
Definition | When a measure includes multiple stratifiers, there will be a stratifier group for each stratifier defined by the measure.
Short | Stratification results
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) deqm-7: 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()`)
118. MeasureReport.group.stratifier.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `MeasureReport.group.stratifier.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
120. MeasureReport.group.stratifier.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id for group.stratifier from the measure.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for MeasureReport.group.stratifier.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
122. MeasureReport.group.stratifier.extension:description
Slice Name | description
Definition | A description of the group, population, stratifier, or supplemental data definition on which it appears. This is typically a restatement of the description of the corresponding element in the Measure being reported, but may also include additional information gathered by the reporting process.
Short | Description of the stratifier
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Measure Report Population Description) (Extension Type: markdown)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
124. MeasureReport.group.stratifier.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
126. MeasureReport.group.stratifier.code
Definition | The meaning of this stratifier, as defined in the measure definition.
Short | What stratifier of the group
Control | 0..1*
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
128. MeasureReport.group.stratifier.stratum
Definition | This element contains the results for a single stratum within the stratifier. For example, when stratifying on administrative gender, there will be four strata, one for each possible gender value.
Short | Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
130. MeasureReport.group.stratifier.stratum.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
132. MeasureReport.group.stratifier.stratum.component
Definition | A stratifier component value.
Short | Stratifier component values
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
134. MeasureReport.group.stratifier.stratum.component.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `MeasureReport.group.stratifier.stratum.component.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
136. MeasureReport.group.stratifier.stratum.component.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id for group.stratifier.component from the measure.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for MeasureReport.group.stratifier.stratum.component.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
138. MeasureReport.group.stratifier.stratum.component.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
140. MeasureReport.group.stratifier.stratum.component.code
Definition | The code for the stratum component value.
Short | What stratifier component of the group
Control | 1..1
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
142. MeasureReport.group.stratifier.stratum.component.value
Definition | The stratum component value.
Short | The stratum component value, e.g. male
Control | 1..1
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
144. MeasureReport.group.stratifier.stratum.population
Definition | The populations that make up the stratum, one for each type of population appropriate to the measure.
Short | Population results in this stratum
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) deqm-9: 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()`)
146. MeasureReport.group.stratifier.stratum.population.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `MeasureReport.group.stratifier.stratum.population.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
148. MeasureReport.group.stratifier.stratum.population.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id for group.stratifier.population from the measure.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for MeasureReport.group.stratifier.stratum.population.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
150. MeasureReport.group.stratifier.stratum.population.extension:countQuantity
Slice Name | countQuantity
Definition | A Quantity representing the size of the population. This is important to support the case when a population value may result in a decimal when reporting composite measures.
Short | Size of the population as a quantity.
Control | 0..1 This element is affected by the following invariants: ele-1, deqm-9
Type | Extension(Count Quantity) (Extension Type: Quantity)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
152. MeasureReport.group.stratifier.stratum.population.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
154. MeasureReport.group.stratifier.stratum.population.code
Definition | The type of the population.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType http://hl7.org/fhir/ValueSet/measure-population|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/measure-population|4.0.1` ) The type of population (e.g. initial, numerator, denominator, etc.).
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
156. MeasureReport.group.stratifier.stratum.population.count
Definition | The number of members of the population in this stratum.
Short | Size of the population
Control | 10..1 This element is affected by the following invariants: deqm-9
Type | integer
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
158. MeasureReport.group.stratifier.stratum.measureScore
Definition | The measure score for this stratum, calculated as appropriate for the measure type and scoring method, and based on only the members of this stratum.
Short | What score this stratum achieved
Control | 0..1
Type | Quantity
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
160. MeasureReport.group.stratifier.stratum.measureScore.extension:alternateScoreType
Slice Name | alternateScoreType
Definition | Possible value types for the measureScore elements in addition to the standard Quantity type. The alternate type is determined by the Quality Measure Aggregate Method extension used on the Measure. The reported type of the measureScore for continuous variable measures is determined by the result type of the aggregate method operation.
Short | Possible additional measureScore value types
Comments | This extension corresponds to the additional MeasureScore type added to the R5 version of MeasureReport.
Control | 0..1
Type | Extension(DEQM Alternate Score Type Extension) (Extension Type: Choice of: dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
162. MeasureReport.group.stratifier.stratum.measureScore.comparator
Definition | How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Short | < | <= | >= | > - how to understand the value
Control | 0..1
Binding | The codes SHALL be taken from QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 (required to `http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1` ) How the Quantity should be understood and represented.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning if Missing | If there is no comparator, then there is no modification of the value
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
164. MeasureReport.evaluatedResource
Definition | A reference to a Bundle containing the Resources that were used in the calculation of this measure.
Short | What data was used to calculate the measure score
Control | 0..*
Type | Reference(Resource)
Is Modifier | false
Must Support | true
Summary | false
Requirements | To support the reporting of supplemental data elements.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
166. MeasureReport.evaluatedResource.extension:criteriaReference
Slice Name | criteriaReference
Definition | Reference a criteria by specifying that criteria's unique id
Short | Criteria reference
Comments | When used in a MeasureReport, this is a reference to the id of a criteria within the Measure referenced by the MeasureReport.
Control | 0..*
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())

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

0. MeasureReport
Must Support | false
Invariants | deqm-2: 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: 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-5: 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`)
2. MeasureReport.extension:careGapRemark
Slice Name | careGapRemark
Control | 0..*
Type | Extension(DEQM Care Gap Remark Extension) (Complex Extension)
Must Support | true
4. MeasureReport.extension:message
Slice Name | message
Control | 0..1
Type | Extension(Messages) (Extension Type: Reference(OperationOutcome))
6. MeasureReport.extension:category
Slice Name | category
Control | 0..1
Type | Extension(Measure Report Category) (Extension Type: CodeableConcept)
Must Support | true
8. MeasureReport.extension:reportingProgram
Slice Name | reportingProgram
Control | 0..1
Type | Extension(DEQM Reporting Program Extension) (Extension Type: Choice of: Identifier, canonical(CRMI Manifest Library))
10. MeasureReport.extension:inputParameters
Slice Name | inputParameters
Control | 0..1
Type | Extension(Input parameters) (Extension Type: Reference(Parameters))
12. MeasureReport.extension:supplementalData
Slice Name | supplementalData
Control | 0..*
Type | Extension(Extension Definition for MeasureReport.supplementalData for Version 5.0) (Extension Type: Reference(Resource))
Must Support | true
14. MeasureReport.extension:supplementalData.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
16. MeasureReport.extension:supplementalData.value[x].extension:criteriaReference
Slice Name | criteriaReference
Control | 0..1
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Must Support | true
18. MeasureReport.extension:supplementalData.value[x].extension:description
Slice Name | description
Short | Description of the supplemental data
Control | 0..1
Type | Extension(Measure Report Population Description) (Extension Type: markdown)
Must Support | true
20. MeasureReport.extension:scoring
Slice Name | scoring
Short | proportion | ratio | continuous-variable | cohort | composite | attestation
Control | 0..1 This element is affected by the following invariants: deqm-2, deqm-3, deqm-6
Type | Extension(DEQM Measure Scoring Extension) (Extension Type: CodeableConcept)
Must Support | true
22. MeasureReport.extension:vendor
Slice Name | vendor
Control | 0..1
Type | Extension(DEQM Reporting Vendor Extension) (Extension Type: Reference(Organization))
24. MeasureReport.extension:cehrt
Slice Name | cehrt
Short | CMS EHR Certification ID
Control | 0..1
Type | Extension(DEQM Certification Identifier Extension) (Extension Type: Identifier)
26. MeasureReport.extension:cehrt.valueIdentifier
Control | 1..1
Type | Identifier
Pattern Value | `{ "system" : "urn:oid:2.16.840.1.113883.3.2074.1" }`
28. MeasureReport.extension:software
Slice Name | software
Control | 0..*
Type | Extension(CRMI Software System) (Extension Type: Reference(CRMI Software System Device))
30. MeasureReport.extension:location
Slice Name | location
Control | 0..*
Type | Extension(DEQM Data Location Extension) (Extension Type: Reference(Location))
32. MeasureReport.extension:limitations
Slice Name | limitations
Short | 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.
Control | 0..1
Type | Extension(CQM Limitations) (Extension Type: markdown)
Must Support | true
34. MeasureReport.extension:trendingIssues
Slice Name | trendingIssues
Short | 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.
Control | 0..1
Type | Extension(CQM Trending Issues) (Extension Type: markdown)
Must Support | true
36. MeasureReport.status
Must Support | true
38. MeasureReport.type
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Requirements | For individual quality meaure reporting, this report is constrained to reporting on an individual.
Fixed Value | `individual`
40. MeasureReport.measure
Type | canonical(CRMI Shareable Measure)
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Requirements | This will indicate the measure and version being reported on. For example, the cannonical uri location for the MRP measure.
Invariants | deqm-0: Canonical URL SHALL contain a version. (`%resource.measure.toString().contains('|') and %resource.measure.substring(%resource.measure.toString().indexOf('|') + 1).length() > 0`)
42. MeasureReport.subject
Control | 1..1
Type | Reference(Patient, Practitioner, PractitionerRole, Location, Device, RelatedPerson)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
44. MeasureReport.date
Short | When the report was generated. Note: The language in R5 was changed to calculated. We are clarifying that intent.
Control | 1..1
Must Support | true
46. MeasureReport.reporter
Definition | Who is reporting the data. The reporter is the entity fulfilling the reporting requirement.
Short | Who is reporting the data. The reporter is the entity fulfilling the reporting requirement.
Control | 1..1
Type | Reference(Organization, Practitioner, PractitionerRole)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
48. MeasureReport.period
Short | The period for which the report was calculated. For the gaps in care use case, this is referred to as the gaps through period.
Control | 1..1 This element is affected by the following invariants: deqm-1
Type | Period
Must Support | true
Invariants | deqm-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) (`start.toString().length()>9 and end.toString().length()>9`)
50. MeasureReport.period.start
Control | 1..1
Must Support | true
52. MeasureReport.period.end
Control | 1..1
Must Support | true
54. MeasureReport.improvementNotation
Control | 0..1 This element is affected by the following invariants: deqm-2
Must Support | true
56. MeasureReport.group
Must Support | true
Invariants | deqm-4: 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-6: 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)`)
58. MeasureReport.group.id
Must Support | true
60. MeasureReport.group.extension:linkId
Slice Name | linkId
Short | Unique id of the group from the measure.
Control | 1..1
Type | Extension(Extension Definition for MeasureReport.group.linkId for Version 5.0) (Extension Type: string)
Must Support | true
62. MeasureReport.group.extension:scoring
Slice Name | scoring
Short | proportion | ratio | continuous-variable | cohort | composite | attestation
Control | 0..1 This element is affected by the following invariants: deqm-3
Type | Extension(DEQM Measure Scoring Extension) (Extension Type: CodeableConcept)
Must Support | true
64. MeasureReport.group.extension:cqm-compositeScoring
Slice Name | cqm-compositeScoring
Short | How the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort
Control | 0..1
Type | Extension(CQM Composite Scoring) (Extension Type: CodeableConcept)
Must Support | true
66. MeasureReport.group.extension:calculatedDate
Slice Name | calculatedDate
Control | 0..1
Type | Extension(DEQM Calculated Date Extension) (Extension Type: dateTime)
Must Support | true
68. MeasureReport.group.extension:improvementNotation
Slice Name | improvementNotation
Short | increase | decrease
Control | 0..1 This element is affected by the following invariants: deqm-4
Type | Extension(DEQM Group Improvement Notation Extension) (Extension Type: CodeableConcept)
Must Support | true
70. MeasureReport.group.extension:description
Slice Name | description
Short | Description of the group
Control | 0..1
Type | Extension(Measure Report Population Description) (Extension Type: markdown)
Must Support | true
72. MeasureReport.group.code
Must Support | true
74. MeasureReport.group.population
Must Support | true
Invariants | deqm-8: 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()`)
76. MeasureReport.group.population.extension:linkId
Slice Name | linkId
Short | Unique id for group.population from the measure.
Control | 1..1
Type | Extension(Extension Definition for MeasureReport.group.population.linkId for Version 5.0) (Extension Type: string)
Must Support | true
78. MeasureReport.group.population.extension:countQuantity
Slice Name | countQuantity
Definition | The count of the population represented as a Quantity. This is used in cases where the count may be a decimal value such as in a ratio measure.
Short | Count as a Quantity
Control | 0..1 This element is affected by the following invariants: deqm-8
Type | Extension(Count Quantity) (Extension Type: Quantity)
Must Support | true
80. MeasureReport.group.population.extension:description
Slice Name | description
Short | Description of the population
Control | 0..1
Type | Extension(Measure Report Population Description) (Extension Type: markdown)
Must Support | true
82. MeasureReport.group.population.extension:supportingEvidence
Slice Name | supportingEvidence
Short | Specifies the result of a supporting evidence expression in the measure population.
Control | 0..*
Type | Extension(`http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidence`)
Must Support | true
84. MeasureReport.group.population.code
Control | 1..1
Must Support | true
86. MeasureReport.group.population.count
Control | 0..1 This element is affected by the following invariants: deqm-8
Must Support | true
88. MeasureReport.group.population.subjectResults
Control | 0..0
Must Support | false
90. MeasureReport.group.measureScore
Comments | For individual reporting, the measure score is calculated for the individual. For a proportion measure, it would be 0.0 or 1.0 (indicating 0% or 100%).
Control | 0..1 This element is affected by the following invariants: deqm-6
Must Support | true
92. MeasureReport.group.measureScore.extension:alternateScoreType
Slice Name | alternateScoreType
Control | 0..1
Type | Extension(DEQM Alternate Score Type Extension) (Extension Type: Choice of: dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio)
Must Support | true
94. MeasureReport.group.stratifier
Must Support | true
Invariants | deqm-7: 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()`)
96. MeasureReport.group.stratifier.extension:linkId
Slice Name | linkId
Short | Unique id for group.stratifier from the measure.
Control | 1..1
Type | Extension(Extension Definition for MeasureReport.group.stratifier.linkId for Version 5.0) (Extension Type: string)
Must Support | true
98. MeasureReport.group.stratifier.extension:description
Slice Name | description
Short | Description of the stratifier
Control | 0..1
Type | Extension(Measure Report Population Description) (Extension Type: markdown)
Must Support | true
100. MeasureReport.group.stratifier.code
Control | 0..1
Must Support | true
102. MeasureReport.group.stratifier.stratum
Must Support | true
104. MeasureReport.group.stratifier.stratum.component
106. MeasureReport.group.stratifier.stratum.component.extension:linkId
Slice Name | linkId
Short | Unique id for group.stratifier.component from the measure.
Control | 1..1
Type | Extension(Extension Definition for MeasureReport.group.stratifier.stratum.component.linkId for Version 5.0) (Extension Type: string)
Must Support | true
108. MeasureReport.group.stratifier.stratum.population
Must Support | true
Invariants | deqm-9: 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()`)
110. MeasureReport.group.stratifier.stratum.population.extension:linkId
Slice Name | linkId
Short | Unique id for group.stratifier.population from the measure.
Control | 1..1
Type | Extension(Extension Definition for MeasureReport.group.stratifier.stratum.population.linkId for Version 5.0) (Extension Type: string)
Must Support | true
112. MeasureReport.group.stratifier.stratum.population.extension:countQuantity
Slice Name | countQuantity
Control | 0..1 This element is affected by the following invariants: deqm-9
Type | Extension(Count Quantity) (Extension Type: Quantity)
Must Support | true
114. MeasureReport.group.stratifier.stratum.population.code
Control | 1..1
Must Support | true
116. MeasureReport.group.stratifier.stratum.population.count
Control | 1..1 This element is affected by the following invariants: deqm-9
Must Support | true
118. MeasureReport.group.stratifier.stratum.measureScore
Must Support | true
120. MeasureReport.group.stratifier.stratum.measureScore.extension:alternateScoreType
Slice Name | alternateScoreType
Control | 0..1
Type | Extension(DEQM Alternate Score Type Extension) (Extension Type: Choice of: dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio)
Must Support | true
122. MeasureReport.evaluatedResource
Must Support | true
Requirements | To support the reporting of supplemental data elements.
124. MeasureReport.evaluatedResource.extension:criteriaReference
Slice Name | criteriaReference
Control | 0..*
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Must Support | true

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

0. MeasureReport
Definition | The MeasureReport resource contains the results of the calculation of a measure; and optionally a reference to the resources involved in that calculation.
Short | Results of a measure evaluation
Control | 0..*
Is Modifier | false
Must Support | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (`contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (`contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`) mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information (`(type != 'data-collection') or group.exists().not()`) mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components (`group.stratifier.stratum.all(value.exists() xor component.exists())`) deqm-2: 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: 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-5: 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`)
2. MeasureReport.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. MeasureReport.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. MeasureReport.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. MeasureReport.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. MeasureReport.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. MeasureReport.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. MeasureReport.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MeasureReport.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. MeasureReport.extension:careGapRemark
Slice Name | careGapRemark
Definition | Remark about a Condition Category.
Short | Condition Category remark
Control | 0..* This element is affected by the following invariants: ele-1, cgr-1
Type | Extension(DEQM Care Gap Remark Extension) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) cgr-1: A remark shall include an author, an authorOrganization, or an authorSoftware (`extension.where(url = 'author').exists() or extension.where(url = 'authorOrganization').exists() or extension.where(url = 'authorSoftware').exists()`)
18. MeasureReport.extension:message
Slice Name | message
Definition | An OperationOutcome resource with information, warning, or error messages that were generated as part of processing an operation.
Short | Evaluation messages
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Messages) (Extension Type: Reference(OperationOutcome))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
20. MeasureReport.extension:category
Slice Name | category
Definition | Specifies the category of a measure report.
Short | What category is this measure report
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Measure Report Category) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
22. MeasureReport.extension:reportingProgram
Slice Name | reportingProgram
Definition | Reference the reporting program by referencing their unique id specified in a Library resource that conforms to the Quality Program profile.
Short | Reporting program
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(DEQM Reporting Program Extension) (Extension Type: Choice of: Identifier, canonical(CRMI Manifest Library))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
24. MeasureReport.extension:inputParameters
Slice Name | inputParameters
Definition | Specifies the input parameters to the operation (such as a test case description or a data requirements or evaluate operation). This extension can be used as part of the result of an operation to indicate what the parameters were, but it can also be used as part of the definition of a test case to specify what the input parameters are expected to be for the test case.
Short | What parameters
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Input parameters) (Extension Type: Reference(Parameters))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
26. MeasureReport.extension:supplementalData
Slice Name | supplementalData
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for MeasureReport.supplementalData for Version 5.0) (Extension Type: Reference(Resource))
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
28. MeasureReport.extension:supplementalData.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
30. MeasureReport.extension:supplementalData.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MeasureReport.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
32. MeasureReport.extension:supplementalData.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.supplementalData`
34. MeasureReport.extension:supplementalData.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1
Type | Reference(Resource)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. MeasureReport.extension:supplementalData.value[x].id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
38. MeasureReport.extension:supplementalData.value[x].extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MeasureReport.extension.value[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
40. MeasureReport.extension:supplementalData.value[x].extension:criteriaReference
Slice Name | criteriaReference
Definition | Reference a criteria by specifying that criteria's unique id
Short | Criteria reference
Comments | When used in a MeasureReport, this is a reference to the id of a criteria within the Measure referenced by the MeasureReport.
Control | 0..1
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
42. MeasureReport.extension:supplementalData.value[x].extension:description
Slice Name | description
Definition | A description of the group, population, stratifier, or supplemental data definition on which it appears. This is typically a restatement of the description of the corresponding element in the Measure being reported, but may also include additional information gathered by the reporting process.
Short | Description of the supplemental data
Control | 0..1
Type | Extension(Measure Report Population Description) (Extension Type: markdown)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
44. MeasureReport.extension:supplementalData.value[x].reference
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Short | Literal reference, Relative, internal or absolute URL
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Control | 0..1 This element is affected by the following invariants: ref-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. MeasureReport.extension:supplementalData.value[x].type
Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Short | Type the reference refers to (e.g. "Patient")
Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` ) Aa resource (or, for logical models, the URI of the logical model).
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. MeasureReport.extension:supplementalData.value[x].identifier
Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Short | Logical reference, when literal reference is not known
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. MeasureReport.extension:supplementalData.value[x].display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Short | Text alternative for the resource
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. MeasureReport.extension:scoring
Slice Name | scoring
Definition | Optional Extension Element - found in all resources.
Short | proportion | ratio | continuous-variable | cohort | composite | attestation
Control | 0..1 This element is affected by the following invariants: ele-1, deqm-2, deqm-3, deqm-6
Type | Extension(DEQM Measure Scoring Extension) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
54. MeasureReport.extension:vendor
Slice Name | vendor
Definition | A reference to the vendor who queried the data, calculated results and/or generated the report.
Short | Vendor information
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(DEQM Reporting Vendor Extension) (Extension Type: Reference(Organization))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
56. MeasureReport.extension:cehrt
Slice Name | cehrt
Definition | An identifier that represents the EHR certication number (CERHT). See Certified EHR Technology For more information.
Short | CMS EHR Certification ID
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(DEQM Certification Identifier Extension) (Extension Type: Identifier)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
58. MeasureReport.extension:cehrt.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
60. MeasureReport.extension:cehrt.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MeasureReport.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
62. MeasureReport.extension:cehrt.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-certificationIdentifier`
64. MeasureReport.extension:cehrt.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1
Type | Identifier
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `MeasureReport.extension.value[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
66. MeasureReport.extension:cehrt.value[x]:valueIdentifier
Slice Name | valueIdentifier
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1
Type | Identifier
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Pattern Value | `{ "system" : "urn:oid:2.16.840.1.113883.3.2074.1" }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. MeasureReport.extension:software
Slice Name | software
Definition | Specifies the software systems used in the packaging and testing of knowledge artifacts. Specifically to support explicitly stating which versions of the various software components were used in the authoring, packaging, and testing.
Short | Extension
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(CRMI Software System) (Extension Type: Reference(CRMI Software System Device))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
70. MeasureReport.extension:location
Slice Name | location
Definition | Location from which reported data was gathered. This extension is used to provide the location(s) from which reported data was gathered in a MeasureReport, such as individual, summary and data exchange measure report.
Short | Location(s) from which reported data was gathered
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(DEQM Data Location Extension) (Extension Type: Reference(Location))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
72. MeasureReport.extension:limitations
Slice Name | limitations
Definition | identifies what limitations should be noted, including potential selection biases and confounding factors when interpreting indicator results or comparing results across the country.
Short | 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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Limitations) (Extension Type: markdown)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
74. MeasureReport.extension:trendingIssues
Slice Name | trendingIssues
Definition | identifies what issues might affect the interpretation of trending results, including changes in geographic coverage, data quality, coding standards and classification changes (for example, a new ICD standard).
Short | 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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Trending Issues) (Extension Type: markdown)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
76. MeasureReport.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
78. MeasureReport.identifier
Definition | A formal identifier that is used to identify this MeasureReport when it is represented in other formats or referenced in a specification, model, design or an instance.
Short | Additional identifier for the MeasureReport
Comments | Typically, this is used for identifiers that can go in an HL7 V3 II data type - e.g. to identify this {{title}} outside of FHIR, where the logical URL is not possible to use.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Summary | true
Requirements | Allows externally provided and/or usable business identifiers to be easily associated with the module.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. MeasureReport.status
Definition | The MeasureReport status. No data will be available until the MeasureReport status is complete.
Short | complete | pending | error
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from MeasureReportStatus (required to `http://hl7.org/fhir/ValueSet/measure-report-status|4.0.1` ) The status of the measure report.
Type | code
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. MeasureReport.type
Definition | The type of measure report. This may be an individual report, which provides the score for the measure for an individual member of the population; a subject-listing, which returns the list of members that meet the various criteria in the measure; a summary report, which returns a population count for each of the criteria in the measure; or a data-collection, which enables the MeasureReport to be used to exchange the data-of-interest for a quality measure.
Short | individual | subject-list | summary | data-collection
Comments | Data-collection reports are used only to communicate data-of-interest for a measure. They do not necessarily include all the data for a particular subject or population, but they may.
Control | 1..1 This element is affected by the following invariants: mrp-1
Binding | The codes SHALL be taken from MeasureReportType (required to `http://hl7.org/fhir/ValueSet/measure-report-type|4.0.1` ) The type of the measure report.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | For individual quality meaure reporting, this report is constrained to reporting on an individual.
Fixed Value | `individual`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. MeasureReport.measure
Definition | A reference to the Measure that was calculated to produce this report.
Short | What measure was calculated
Control | 1..1 This element is affected by the following invariants: deqm-0
Type | canonical(CRMI Shareable Measure)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | This will indicate the measure and version being reported on. For example, the cannonical uri location for the MRP measure.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) deqm-0: Canonical URL SHALL contain a version. (`%resource.measure.toString().contains('|') and %resource.measure.substring(%resource.measure.toString().indexOf('|') + 1).length() > 0`)
86. MeasureReport.subject
Definition | Optional subject identifying the individual or individuals the report is for.
Short | What individual(s) the report is for
Control | 1..1
Type | Reference(Patient, Practitioner, PractitionerRole, Location, Device, RelatedPerson)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
88. MeasureReport.date
Definition | The date this measure report was generated.
Short | When the report was generated. Note: The language in R5 was changed to calculated. We are clarifying that intent.
Control | 1..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
90. MeasureReport.reporter
Definition | Who is reporting the data. The reporter is the entity fulfilling the reporting requirement.
Short | Who is reporting the data. The reporter is the entity fulfilling the reporting requirement.
Control | 1..1
Type | Reference(Organization, Practitioner, PractitionerRole)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
92. MeasureReport.period
Definition | The reporting period for which the report was calculated.
Short | The period for which the report was calculated. For the gaps in care use case, this is referred to as the gaps through period.
Control | 1..1 This element is affected by the following invariants: deqm-1
Type | Period
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) deqm-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) (`start.toString().length()>9 and end.toString().length()>9`)
94. MeasureReport.period.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
96. MeasureReport.period.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MeasureReport.period.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
98. MeasureReport.period.start
Definition | The start of the period. The boundary is inclusive.
Short | Starting time with inclusive boundary
Comments | If the low element is missing, the meaning is that the low boundary is not known.
Control | 1..1 This element is affected by the following invariants: per-1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. MeasureReport.period.end
Definition | The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Short | End time with inclusive boundary, if not ongoing
Comments | The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
Control | 1..1 This element is affected by the following invariants: per-1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Meaning if Missing | If the end of the period is missing, it means that the period is ongoing
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
102. MeasureReport.improvementNotation
Definition | Whether improvement in the measure is noted by an increase or decrease in the measure score.
Short | increase | decrease
Comments | This element is typically defined by the measure, but reproduced here to ensure the measure score can be interpreted. The element is labeled as a modifier because it changes the interpretation of the reported measure score.
Control | 0..1 This element is affected by the following invariants: deqm-2
Binding | The codes SHALL be taken from MeasureImprovementNotation (required to `http://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.1` ) Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.
Type | CodeableConcept
Is Modifier | true because Improvement notation determines how to interpret the measure score (i.e. whether an increase is an improvement)
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
104. MeasureReport.group
Definition | The results of the calculation, one for each population group in the measure.
Short | Measure results for each group
Control | 0..* This element is affected by the following invariants: mrp-1
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) deqm-4: 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-6: 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)`)
106. MeasureReport.group.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
Must Support | true
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
108. MeasureReport.group.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MeasureReport.group.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
110. MeasureReport.group.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id of the group from the measure.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for MeasureReport.group.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
112. MeasureReport.group.extension:scoring
Slice Name | scoring
Definition | Optional Extension Element - found in all resources.
Short | proportion | ratio | continuous-variable | cohort | composite | attestation
Control | 0..1 This element is affected by the following invariants: ele-1, deqm-3
Type | Extension(DEQM Measure Scoring Extension) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
114. MeasureReport.group.extension:cqm-compositeScoring
Slice Name | cqm-compositeScoring
Definition | Indicates how the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort. The value set is extensible, allowing additional measure scoring types to be represented. When present on a group, specifies the scoring to be used for this group, overriding the scoring specified for the overall measure.
Short | How the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(CQM Composite Scoring) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
116. MeasureReport.group.extension:calculatedDate
Slice Name | calculatedDate
Definition | This applies to the date this metric was actually calculated. If your measure calculation draws on stored calculations and there are multiple calculation dates, this extension would not apply, as in the example of a composite measure where the individual measures were calculated on different dates. This would only cover the case where there is only one calculation date.
Short | The date the score was calculated
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(DEQM Calculated Date Extension) (Extension Type: dateTime)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
118. MeasureReport.group.extension:improvementNotation
Slice Name | improvementNotation
Definition | An Extension
Short | increase | decrease
Control | 0..1 This element is affected by the following invariants: ele-1, deqm-4
Type | Extension(DEQM Group Improvement Notation Extension) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
120. MeasureReport.group.extension:description
Slice Name | description
Definition | A description of the group, population, stratifier, or supplemental data definition on which it appears. This is typically a restatement of the description of the corresponding element in the Measure being reported, but may also include additional information gathered by the reporting process.
Short | Description of the group
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Measure Report Population Description) (Extension Type: markdown)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
122. MeasureReport.group.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
124. MeasureReport.group.code
Definition | The meaning of the population group as defined in the measure definition.
Short | Meaning of the group
Control | 0..1
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
126. MeasureReport.group.population
Definition | The populations that make up the population group, one for each type of population appropriate for the measure.
Short | The populations in the group
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) deqm-8: 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()`)
128. MeasureReport.group.population.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
130. MeasureReport.group.population.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MeasureReport.group.population.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
132. MeasureReport.group.population.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id for group.population from the measure.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for MeasureReport.group.population.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
134. MeasureReport.group.population.extension:countQuantity
Slice Name | countQuantity
Definition | The count of the population represented as a Quantity. This is used in cases where the count may be a decimal value such as in a ratio measure.
Short | Count as a Quantity
Control | 0..1 This element is affected by the following invariants: ele-1, deqm-8
Type | Extension(Count Quantity) (Extension Type: Quantity)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
136. MeasureReport.group.population.extension:description
Slice Name | description
Definition | A description of the group, population, stratifier, or supplemental data definition on which it appears. This is typically a restatement of the description of the corresponding element in the Measure being reported, but may also include additional information gathered by the reporting process.
Short | Description of the population
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Measure Report Population Description) (Extension Type: markdown)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
138. MeasureReport.group.population.extension:supportingEvidence
Slice Name | supportingEvidence
Definition | An Extension
Short | Specifies the result of a supporting evidence expression in the measure population.
Control | 0..*
Type | Extension(`http://hl7.org/fhir/StructureDefinition/cqf-supportingEvidence`)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
140. MeasureReport.group.population.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
142. MeasureReport.group.population.code
Definition | The type of the population.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType (extensible to `http://hl7.org/fhir/ValueSet/measure-population|4.0.1` ) The type of population (e.g. initial, numerator, denominator, etc.).
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
144. MeasureReport.group.population.count
Definition | The number of members of the population.
Short | Size of the population
Control | 0..1 This element is affected by the following invariants: deqm-8
Type | integer
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
146. MeasureReport.group.population.subjectResults
Definition | This element refers to a List of subject level MeasureReport resources, one for each subject in this population.
Short | For subject-list reports, the subject results in this population
Control | 0..0
Type | Reference(List)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
148. MeasureReport.group.measureScore
Definition | The measure score for this population group, calculated as appropriate for the measure type and scoring method, and based on the contents of the populations defined in the group.
Short | What score this group achieved
Comments | For individual reporting, the measure score is calculated for the individual. For a proportion measure, it would be 0.0 or 1.0 (indicating 0% or 100%).
Control | 0..1 This element is affected by the following invariants: deqm-6
Type | Quantity
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
150. MeasureReport.group.measureScore.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
152. MeasureReport.group.measureScore.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MeasureReport.group.measureScore.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
154. MeasureReport.group.measureScore.extension:alternateScoreType
Slice Name | alternateScoreType
Definition | Possible value types for the measureScore elements in addition to the standard Quantity type. The alternate type is determined by the Quality Measure Aggregate Method extension used on the Measure. The reported type of the measureScore for continuous variable measures is determined by the result type of the aggregate method operation.
Short | Possible additional measureScore value types
Comments | This extension corresponds to the additional MeasureScore type added to the R5 version of MeasureReport.
Control | 0..1
Type | Extension(DEQM Alternate Score Type Extension) (Extension Type: Choice of: dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
156. MeasureReport.group.measureScore.value
Definition | The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Short | Numerical value (with implicit precision)
Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Precision is handled implicitly in almost all cases of measurement.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
158. MeasureReport.group.measureScore.comparator
Definition | How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Short | < | <= | >= | > - how to understand the value
Control | 0..1
Binding | The codes SHALL be taken from QuantityComparator (required to `http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1` ) How the Quantity should be understood and represented.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning if Missing | If there is no comparator, then there is no modification of the value
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
160. MeasureReport.group.measureScore.unit
Definition | A human-readable form of the unit.
Short | Unit representation
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
162. MeasureReport.group.measureScore.system
Definition | The identification of the system that provides the coded form of the unit.
Short | System that defines coded unit form
Control | 0..1 This element is affected by the following invariants: qty-3
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to know the system that defines the coded form of the unit.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
164. MeasureReport.group.measureScore.code
Definition | A computer processable form of the unit in some unit representation system.
Short | Coded form of the unit
Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Control | 0..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
166. MeasureReport.group.stratifier
Definition | When a measure includes multiple stratifiers, there will be a stratifier group for each stratifier defined by the measure.
Short | Stratification results
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) deqm-7: 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()`)
168. MeasureReport.group.stratifier.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
170. MeasureReport.group.stratifier.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MeasureReport.group.stratifier.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
172. MeasureReport.group.stratifier.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id for group.stratifier from the measure.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for MeasureReport.group.stratifier.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
174. MeasureReport.group.stratifier.extension:description
Slice Name | description
Definition | A description of the group, population, stratifier, or supplemental data definition on which it appears. This is typically a restatement of the description of the corresponding element in the Measure being reported, but may also include additional information gathered by the reporting process.
Short | Description of the stratifier
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Measure Report Population Description) (Extension Type: markdown)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
176. MeasureReport.group.stratifier.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
178. MeasureReport.group.stratifier.code
Definition | The meaning of this stratifier, as defined in the measure definition.
Short | What stratifier of the group
Control | 0..1
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
180. MeasureReport.group.stratifier.stratum
Definition | This element contains the results for a single stratum within the stratifier. For example, when stratifying on administrative gender, there will be four strata, one for each possible gender value.
Short | Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
182. MeasureReport.group.stratifier.stratum.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
184. MeasureReport.group.stratifier.stratum.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
186. MeasureReport.group.stratifier.stratum.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
188. MeasureReport.group.stratifier.stratum.value
Definition | The value for this stratum, expressed as a CodeableConcept. When defining stratifiers on complex values, the value must be rendered such that the value for each stratum within the stratifier is unique.
Short | The stratum value, e.g. male
Control | 0..1
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
190. MeasureReport.group.stratifier.stratum.component
Definition | A stratifier component value.
Short | Stratifier component values
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
192. MeasureReport.group.stratifier.stratum.component.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
194. MeasureReport.group.stratifier.stratum.component.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MeasureReport.group.stratifier.stratum.component.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
196. MeasureReport.group.stratifier.stratum.component.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id for group.stratifier.component from the measure.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for MeasureReport.group.stratifier.stratum.component.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
198. MeasureReport.group.stratifier.stratum.component.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
200. MeasureReport.group.stratifier.stratum.component.code
Definition | The code for the stratum component value.
Short | What stratifier component of the group
Control | 1..1
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
202. MeasureReport.group.stratifier.stratum.component.value
Definition | The stratum component value.
Short | The stratum component value, e.g. male
Control | 1..1
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
204. MeasureReport.group.stratifier.stratum.population
Definition | The populations that make up the stratum, one for each type of population appropriate to the measure.
Short | Population results in this stratum
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) deqm-9: 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()`)
206. MeasureReport.group.stratifier.stratum.population.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
208. MeasureReport.group.stratifier.stratum.population.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MeasureReport.group.stratifier.stratum.population.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
210. MeasureReport.group.stratifier.stratum.population.extension:linkId
Slice Name | linkId
Definition | Optional Extension Element - found in all resources.
Short | Unique id for group.stratifier.population from the measure.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for MeasureReport.group.stratifier.stratum.population.linkId for Version 5.0) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
212. MeasureReport.group.stratifier.stratum.population.extension:countQuantity
Slice Name | countQuantity
Definition | A Quantity representing the size of the population. This is important to support the case when a population value may result in a decimal when reporting composite measures.
Short | Size of the population as a quantity.
Control | 0..1 This element is affected by the following invariants: ele-1, deqm-9
Type | Extension(Count Quantity) (Extension Type: Quantity)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
214. MeasureReport.group.stratifier.stratum.population.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
216. MeasureReport.group.stratifier.stratum.population.code
Definition | The type of the population.
Short | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from MeasurePopulationType (extensible to `http://hl7.org/fhir/ValueSet/measure-population|4.0.1` ) The type of population (e.g. initial, numerator, denominator, etc.).
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
218. MeasureReport.group.stratifier.stratum.population.count
Definition | The number of members of the population in this stratum.
Short | Size of the population
Control | 1..1 This element is affected by the following invariants: deqm-9
Type | integer
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
220. MeasureReport.group.stratifier.stratum.population.subjectResults
Definition | This element refers to a List of subject level MeasureReport resources, one for each subject in this population in this stratum.
Short | For subject-list reports, the subject results in this population
Control | 0..1
Type | Reference(List)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
222. MeasureReport.group.stratifier.stratum.measureScore
Definition | The measure score for this stratum, calculated as appropriate for the measure type and scoring method, and based on only the members of this stratum.
Short | What score this stratum achieved
Control | 0..1
Type | Quantity
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
224. MeasureReport.group.stratifier.stratum.measureScore.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
226. MeasureReport.group.stratifier.stratum.measureScore.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MeasureReport.group.stratifier.stratum.measureScore.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
228. MeasureReport.group.stratifier.stratum.measureScore.extension:alternateScoreType
Slice Name | alternateScoreType
Definition | Possible value types for the measureScore elements in addition to the standard Quantity type. The alternate type is determined by the Quality Measure Aggregate Method extension used on the Measure. The reported type of the measureScore for continuous variable measures is determined by the result type of the aggregate method operation.
Short | Possible additional measureScore value types
Comments | This extension corresponds to the additional MeasureScore type added to the R5 version of MeasureReport.
Control | 0..1
Type | Extension(DEQM Alternate Score Type Extension) (Extension Type: Choice of: dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
230. MeasureReport.group.stratifier.stratum.measureScore.value
Definition | The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Short | Numerical value (with implicit precision)
Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Precision is handled implicitly in almost all cases of measurement.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
232. MeasureReport.group.stratifier.stratum.measureScore.comparator
Definition | How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Short | < | <= | >= | > - how to understand the value
Control | 0..1
Binding | The codes SHALL be taken from QuantityComparator (required to `http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1` ) How the Quantity should be understood and represented.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning if Missing | If there is no comparator, then there is no modification of the value
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
234. MeasureReport.group.stratifier.stratum.measureScore.unit
Definition | A human-readable form of the unit.
Short | Unit representation
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
236. MeasureReport.group.stratifier.stratum.measureScore.system
Definition | The identification of the system that provides the coded form of the unit.
Short | System that defines coded unit form
Control | 0..1 This element is affected by the following invariants: qty-3
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to know the system that defines the coded form of the unit.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
238. MeasureReport.group.stratifier.stratum.measureScore.code
Definition | A computer processable form of the unit in some unit representation system.
Short | Coded form of the unit
Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Control | 0..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
240. MeasureReport.evaluatedResource
Definition | A reference to a Bundle containing the Resources that were used in the calculation of this measure.
Short | What data was used to calculate the measure score
Control | 0..*
Type | Reference(Resource)
Is Modifier | false
Must Support | true
Summary | false
Requirements | To support the reporting of supplemental data elements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
242. MeasureReport.evaluatedResource.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
244. MeasureReport.evaluatedResource.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MeasureReport.evaluatedResource.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
246. MeasureReport.evaluatedResource.extension:criteriaReference
Slice Name | criteriaReference
Definition | Reference a criteria by specifying that criteria's unique id
Short | Criteria reference
Comments | When used in a MeasureReport, this is a reference to the id of a criteria within the Measure referenced by the MeasureReport.
Control | 0..*
Type | Extension(Criteria Reference Extension) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
248. MeasureReport.evaluatedResource.reference
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Short | Literal reference, Relative, internal or absolute URL
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Control | 0..1 This element is affected by the following invariants: ref-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
250. MeasureReport.evaluatedResource.type
Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Short | Type the reference refers to (e.g. "Patient")
Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` ) Aa resource (or, for logical models, the URI of the logical model).
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
252. MeasureReport.evaluatedResource.identifier
Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Short | Logical reference, when literal reference is not known
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
254. MeasureReport.evaluatedResource.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Short | Text alternative for the resource
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)