The Measure resource provides the definition of a quality measure.

An absolute URI that is used to identify this measure when it is referenced in a specification, model, design or an instance. instance; also called its canonical identifier. This SHALL be a URL, SHOULD be globally unique, unique and SHOULD be an a literal address at which an authoritative instance of this measure is (or will be) published. The This URL SHOULD include can be the major version target of a canonical reference. It SHALL remain the measure. For more information see Technical and Business Versions . same when the measure is stored on different servers.

Allows the measure to be referenced by a single globally unique identifier.

Can be a urn:uuid: or a urn:oid:, urn:oid: but real http: addresses are preferred. Multiple instances may share the same url URL if they have a distinct version.

The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions .

In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.

A formal identifier that is used to identify this measure when it is represented in other formats, or referenced in a specification, model, design or an instance.

Allows externally provided and/or usable business identifiers to be easily associated with the module.

The identifier that is used to identify this version of the measure when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the measure author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifacts.

There may be different measure instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a refrence reference to a particular business version of the measure with the format [url]|[version]. The version SHOULD NOT contain a '#' - see Business Version .

Indicates the mechanism used to compare versions to determine which is more current.

If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.

A natural language name identifying the measure. This name should be usable as an identifier for the module by machine processing applications such as code generation.

Support human navigation and code generation.

The name is not expected to be globally unique. The name should be a simple alpha-numeric alphanumeric type name to ensure that it is computable machine-processing friendly.

A short, descriptive, user-friendly title for the measure.

This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

An explanatory or alternate title for the measure giving additional information about its content.

The status of this measure. Enables tracking the life-cycle of the content.

Allows filtering of measures that are appropriate for use vs. versus not. This is labeled as "Is Modifier" because applications should not use a retired measure without due consideration.

See guidance around (not) making local changes to elements here .

A boolean Boolean value to indicate that this measure is authored for testing purposes (or education/evaluation/marketing), education/evaluation/marketing) and is not intended to no version of this resource will ever be used intended for genuine usage.

Enables experimental content to be developed following the same lifecycle that would be used for a production-level measure.

Allows filtering of measure measures that are appropriate for use vs. versus not. This Experimental resources might include example instances in implementation guides, instances created solely for testing purposes, etc. If experimental is labeled as "Is Modifier" because applications 'true' for any version of a resource, it should be true for all versions of the resource. (If experimental changes, then it is being misused or a resource that was never intended for real-world use has unexpectedly changed its purpose.).

Experimental resources are not expected to be stable and may well have breaking changes without a corresponding change to the 'version' element.

The intended subjects for the measure. If this element is not provided, a Patient subject is assumed, but the subject of the measure can be anything.

The subject of the measure is critical in production. interpreting the criteria definitions, as the logic in the measures is evaluated with respect to a particular subject. This corresponds roughly to the notion of a Compartment in that it limits what content is available based on its relationship to the subject. In CQL, this corresponds to the context declaration. If the subject is specified as a reference to a Group, it must be a definitional group.

The date (and optionally time) when the measure was published. last significantly changed. The date must change if and when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the measure changes.

The date is often not tracked until the resource is published, but may be present on draft content. Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the measure. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

See guidance around (not) making local changes to elements here .

The name of the individual or organization that published or individual responsible for the release and ongoing maintenance of the measure.

Helps establish the "authority/credibility" "authority/credibility" of the measure. May also allow for contact.

Usually an organization, organization but may be an individual. The publisher (or steward) of the measure is the organization or individual primarily responsible for the maintenance and upkeep of the measure. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the measure. This item SHOULD be populated unless the information is available from context.

Contact details to assist a user in finding and communicating with the publisher.

May be a web site, an email address, a telephone number, etc.

See guidance around (not) making local changes to elements here .

A free text natural language description of the measure from a consumer's perspective.

This description can be used to capture details such as why the measure was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the measure as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the profile measure is presumed to be the predominant language in the place the profile measure was created).

The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate measure instances.

Assist in searching for appropriate content.

When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

A legal or geographic region in which the authority that maintains the resource is operating. In general, the jurisdiction is also found in the useContext. The useContext may reference additional jurisdictions because the defining jurisdiction does not necessarily limit the jurisdictions of use.

It may be possible for the measure to be used in jurisdictions other than those for which it was originally designed or intended.

DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to using the new 'jurisdiction' code in the useContext element. (I.e. useContext.code indicating http://terminology.hl7.org/CodeSystem/usage-context-type#jurisdiction and useContext.valueCodeableConcept indicating the jurisdiction.)

Explaination Explanation of why this measure is needed and why it has been designed as it has.

This element does not describe the usage of the measure Instead measure. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this measure.

A detailed description description, from a clinical perspective, of how the measure is used from a used.

Measure developers must be able to provide additional guidance for implementers to understand the intent with greater specificity than that provided in the population criteria of the measure. This element provides detailed guidance, where the usage element provides a summary of the guidance.

This metadata element was typically referred to as Guidance in HQMF

A copyright statement relating to the measure and/or its contents. Copyright statements are notices of intellectual property ownership and can include restrictions on the use and publishing of the measure.

Consumers must be able to determine any legal restrictions on the use of the measure and/or its content.

The short copyright declaration (e.g. (c) '2015+ xyz organization') should be sent in the copyrightLabel element without the copyright prefix (i.e., do not include '(c)' or the symbol).

A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are restricted. (e.g. 'All rights reserved', 'Some rights reserved').

Defines the content expected to be rendered in all representations of the artifact.

The copyright symbol and the '(c)' textual representation SHOULD NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

The 'date' element may be more recent than the approval date because of minor changes / or editorial corrections.

See guidance around (not) making local changes to elements here .

The date on which the resource content was last reviewed. Review happens periodically after approval, approval but doesn't does not change the original approval date.

Gives a sense of how "current" "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

If specified, this is usually after date follows the original approval date.

See guidance around (not) making local changes to elements here .

The period during which the measure content was or is planned to be in active use.

Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of a the measure are or are expected to be used instead.

The effective period for a measure determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.

The content was developed with a focus and intent of supporting the contexts that are listed. These terms may be used See guidance around (not) making local changes to assist with indexing and searching for appropriate measure instances. elements here .

When multiple useContexts are specified, there is no expectation whether all or any of The frequency that this measure should be reported, usually specified by the contexts apply. program it is being submitted to.

Allows the reporting frequency for the given program to be specified in the Measure itself.

It may be possible for Note that reporting frequency is often specified by the measure to be used in jurisdictions other than those for which it was originally designed expectations of a quality program or intended. initiative that is making use of the measure, rather than on the measure directly.

Descriptive topics related to the content of the measure. Topics provide a high-level categorization grouping types of the type of the measure measures that can be useful for filtering and searching.

Repositories must be able to determine how to categorize the measure so that it can be found by topical searches.

DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to using the new 'topic' code in the useContext element. (I.e. useContext.code indicating http://terminology.hl7.org/CodeSystem/usage-context-type#topic and useContext.valueCodeableConcept indicating the topic)

A contributor to An individiual or organization primarily involved in the content creation and maintenance of the measure, including authors, editors, reviewers, and endorsers. content.

Consumers An individual or organization primarily responsible for internal coherence of the content must be able to quickly determine who contributed to content.

Contact details An individual or organization asserted by the publisher to assist a user in finding and communicating with be primarily responsible for review of some aspect of the publisher. content.

May be a web site, an email address, a telephone number, etc. See guidance around (not) making local changes to elements here .

A copyright statement relating to An individual or organization asserted by the measure and/or its contents. Copyright statements are generally legal restrictions on publisher to be responsible for officially endorsing the content for use and publishing of the measure. in some setting.

See guidance around (not) making local changes to elements here .

Related artifacts such as additional documentation, justification, or bibliographic references.

Measures must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.

Each related artifact is either an attachment, or a reference to another resource, but not both. In addition, the successor or predecessor of a Measure SHOULD be a Measure, and dependencies and components of a Measure SHOULD reference a resource.

A reference to a Library resource containing the formal logic used by the measure.

Notices and disclaimers regarding the use of the measure, measure or related to intellectual property (such as code systems) referenced by the measure.

Some organizations require that notices and disclosures be included when publishing measures that reference their intellecutal property.

A description of the risk adjustment factors that may impact the resulting score for the measure and how they may be accounted for when computing and reporting measure results.

Describes the method of adjusting for clinical severity and conditions present at the start of care that can influence patient outcomes for making valid comparisons of outcome measures across providers. Indicates whether a measure is subject to the statistical process for reducing, removing, or clarifying the influences of confounding factors to allow for more useful comparisons.

Describes how to combine the calculation information calculated, based on logic in each of several populations, into one summarized result.

The measure rate for an organization or clinician is based upon the measure, including proportion, ratio, continuous variable, entities’ aggregate data and cohort. summarizes the performance of the entity over a given time period (e.g., monthly, quarterly, yearly). The value set is extensible, allowing additional aggregated data are derived from the results of a specific measure scoring types algorithm and, if appropriate, the application of specific risk adjustment models. Can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure (e.g., pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two). This could be represented. applied to aggregated cohort measure definitions (e.g., CDC's aggregate reporting for TB at the state level).

Provides a detailed justification of the need for the measure including statements pertaining to importance criterion: impact, gap in care, and evidence.

Measure developers need to be able to provide a detailed description of the purpose of the measure. This element provides detailed rationale, where the purpose element provides a summary of the rationale.

Provides a summary of relevant clinical guidelines or other clinical recommendations supporting the measure.

Provides a description of an individual term used within the measure.

Measure developers must be able to provide precise definitions of terms used within measure descriptions and guidance to help communicate the intent of the measure.

A codeable representation of the defined term.

Provides a definition for the term as used within the measure.

Additional guidance for the measure including how it can be used in a clinical context, and the intent of the measure.

If this Measure developers must be able to provide additional guidance for implementers to understand the intent with greater specificity than that provided in the population criteria of the measure. This element provides detailed guidance, where the usage element provides a summary of the guidance.

NOTE: This element is deprecated in favor of the usage element

A group of population criteria for the measure.

An identifier that is unique within the scoring method used Measure allowing linkage to combine the component measures equivalent item in a MeasureReport resource.

MeasureReport does not require omitted groups to determine be included.

This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.

LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such

Indicates the composite score. title for the group.

Indicates a meaning for the group. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing groups to be correlated across measures.

The human readable description of this population group.

Indicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilization.

The intended subjects for the measure. If this element is not provided, there is no subject context (i.e. population criteria are evaluated from the perspective of the entire system, rather than from the perspective of a particular subject).

A description The subject of the risk adjustment factors measure is critical in interpreting the criteria definitions, as the logic in the measures is evaluated with respect to a particular subject. This corresponds roughly to the notion of a Compartment in that may impact it limits what content is available based on its relationship to the resulting score subject. In CQL, this corresponds to the context declaration. If the subject is specified as a reference to a Group, it must be a definitional group.

The population basis specifies the type of elements in the population. For a subject-based measure, this is boolean (because the subject and the population basis are the same, and the population criteria define yes/no values for each individual in the population). For measures that have a population basis that is different than the subject, this element specifies the type of the population basis. For example, an encounter-based measure has a subject of Patient and how they a population basis of Encounter, and the population criteria all return lists of Encounters.

Allows non-subject-based measures to be specified (i.e. encounter-based and procedure-based)

Specifies population basis requirements (i.e. what constitutes a case, or what is being counted) as a DataRequirement. If multiple basisRequirements are specified, criteria expressions may return data that satisfies ANY basisRequirement. A data element satisfies a basisRequirement if the instance is of the type, conforms to ALL the specified profiles, and matches ALL the codeFilters. basisRequirements SHALL specify type, MAY specify profile and codeFilter, and SHALL NOT specify dateFilter, valueFilter, limit, or sort. If basis is specified, any basisRequirement SHALL be accounted consistent with the specified basis (i.e. the type of each basisRequirement SHALL be the same type as, or a subtype of the basis type).

Allows population basis to be described with more flexibility, including the use of a profile and a code filter.

Indicates how the calculation is performed for when computing the measure, including proportion, ratio, continuous-variable, and reporting cohort. The value set is extensible, allowing additional measure results. scoring types to be represented.

Describes Defines the method expected units of adjusting measure for clinical severity and conditions present at the start measure score. This element SHOULD be specified as a UCUM unit.

When the unit cannot be inferred directly from the calculation logic, this element allows the specification of care the desired units of measure of the output.

When this element is specified, implementations are expected to report measure scores in the specified units. Note that can influence patient outcomes for making valid comparisons this may involve unit conversion if the expected units are different than the units of outcome measures across providers. Indicates whether an eMeasure the resulting score calculation. In this case, unit conversions SHALL be performed according to the unit conversion semantics specified by UCUM.

When the score is subject a decimal value this should be used to specify the statistical process expected minimum number of digits after the decimal point to use for reducing, removing, or clarifying the influences precision of confounding factors the value. When a scoringUnit is also specified, this value is the expected minimum number of digits after the decimal point when the score is expressed in the units specified.

If this is a composite measure, the scoring method used to combine the component measures to determine the composite score.

If this is a composite measure, a component of the composite.

The measure that contains the definition of the component calculation.

Specifies the id of a particular group within the measure referenced by the related artifact resource.

When referencing a component of a composite measure, if the referenced measure contains multiple rates, this element specifies which particular rate is to be used as the component.

What is the weight of the contribution of this measure to the overall score.

When computing weighted composite measures, the weight of each contribution must be specified.

Describes how to combine the information calculated, based on logic in each of several populations, into one summarized result.

The measure rate for an organization or clinician is based upon the entities’ entities' aggregate data and summarizes the performance of the entity over a given time period (e.g., monthly, quarterly, yearly). The aggregated data are derived from the results of a specific measure algorithm and, if appropriate, the application of specific risk adjustment models. Can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure (e.g., pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two). This could be applied to aggregated cohort measure definitions (e.g., CDC's aggregate reporting for TB at the state level).

Provides a succint statement of Information on whether an increase or decrease in score is the need preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range). Exercise caution when using any values besides increase or decrease for the measure. Usually includes statements pertaining to importance criterion: impact, gap in care, and evidence. improvementNotation.

Measure consumers and implementers must be able to determine how to interpret a measure score.

Provides a summary of relevant clinical guidelines or other clinical recommendations supporting Narrative text to explain the measure. improvement notation and how to interpret it.

This element allows explanation to the improvementNotation be provided. In some cases, additional guidance is required to clearly communicate measure intent around improvement notation. For example, a measure looking at Ceasarean-section births may have an improvement notation of “decrease”, but it is critical to be able to communicate that a measure score of 0 is not the intent.

Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is whthin A reference to a range). Library resource containing the formal logic used by the measure group.

Measure consumers and implementers must be able to determine how to interpret a measure score. A population criteria for the measure.

Provides a description of an individual term used An identifier that is unique within the measure. Measure allowing linkage to the equivalent population in a MeasureReport resource.

MeasureReport does not require omitted populations to be included.

Measure developers must This ''can'' be able a meaningful identifier (e.g. a LOINC code) but is not intended to provide precise definitions of terms used within measure descriptions have any meaning. GUIDs or sequential numbers are appropriate here.

LinkIds can have whitespaces and guidance to help communicate the intent of the measure. slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such

Additional guidance for Indicates the measure including how it can be used in a clinical context, and title for the intent group's population.

Measure developers must be able to provide additional guidance for implementers to understand the intent with greater specificity than that provided in the logic The type of the measure. population criteria.

The measure set, e.g. Preventive Care and Screening. human readable description of this population criteria.

A group of population An expression that specifies the criteria for the measure. population, typically the name of an expression in a library.

A unique identifier for In the group. This identifier will used to report data case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the group population. For these types of measures, individual observations are reported as observation resources included in the measure report. evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information. As with any expression-valued element, the cqf-alternativeExpression extension may be used to provide an expression in an alternate language.

A Group resource that defines this population as a set of characteristics.

Note that this approach can only be used for measures where the basis is of the same type as the populations (e.g. a Patient-based measure, rather than an Encounter-based measure). In addition, the referenced Group resource SHALL be a definitional (as opposed to an actual) group.

Optional name or short description The id of a population element in this group. measure that provides the input for this population criteria. In most cases, the scoring structure of the measure implies specific relationships (e.g. the Numerator uses the Denominator as the source in a proportion scoring). In some cases, however, multiple possible choices exist and must be resolved explicitly. For example in a ratio measure with multiple initial populations, the denominator must specify which population should be used as the starting point.

For ratio and continuous variable measures, the source populations must be specified explicitly when they cannot be unambiguously determined from the scoring structure.

The human readable description Specifies which method should be used to aggregate measure observation values. For most scoring types, this is implied by scoring (e.g. a proportion measure counts members of the populations). For continuous variables, however, this population group. information must be specified to ensure correct calculation.

For continuous variable measures, specifications must be able to indicate the aggregation method to be used for tallying results from individual observations.

A population criteria stratifier for the measure. measure, specified as either a criteria expression, or a set of components that define value-based stratifier expressions.

A unique identifier for the population criteria. This An identifier that is used to report data against this criteria unique within the Measure allowing linkage to the equivalent item in a MeasureReport resource.

MeasureReport does not require omitted stratifiers to be included.

This is a business identifer, not ''can'' be a resource meaningful identifier (see discussion ) (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.

LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such

Indicates the title for the stratifier of the group.

The type of population criteria. Indicates a meaning for the stratifier. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing stratifiers to be correlated across measures.

Optional name or short The human readable description of this population. stratifier criteria.

The human readable description An expression that specifies a criteria-based stratifier for the measure. This is typically the name of this an expression defined within a referenced library, and SHALL use the same basis as other population criteria. criteria for the population group.

As with any expression-valued element, the cqf-alternativeExpression extension may be used to provide an expression in an alternate language.

The name of a valid referenced CQL expression (may be namespaced) A Group resource that defines this population criteria. as a set of characteristics.

In the case of a continuous variable or ratio measure, Note that this may approach can only be the name of a function that calculates the value of the individual observation used for each patient or event in measures where the population. For these types basis is of measures, individual observations are reported the same type as observation resources included in the evaluatedResources bundle for each patient. See populations (e.g. a Patient-based measure, rather than an Encounter-based measure). In addition, the MeasureReport resource or referenced Group SHALL be a definitional (as opposed to an actual) group. As with any expression-valued element, the Quality Reporting topic for more information. cqf-alternativeExpression extension may be used to provide an expression in an alternate language.

The A component of a value-based stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library, library or a valid FHIR Resource Path.

Stratifiers are defined either as a single criteria, or as a set of component criteria.

The An identifier for that is unique within the stratifier used Measure allowing linkage to coordinate the reported data back equivalent item in a MeasureReport resource.

MeasureReport does not require omitted stratifier components to this stratifier. be included.

This is ''can'' be a business identifer, meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.

LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such

Indicates a resource identifier (see discussion meaning for the stratifier component. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing stratifiers to be correlated across measures.

The human readable description of this stratifier criteria component.

The criteria An expression that returns the value of this component of the stratifier for a member of the stratifier. population. This must be is typically the name of an expression defined within a referenced library. library, but it may also be a path to a stratifier element, evaluated from the perspective of the measure subject. If this is a non-subject-based measure, the expression may be a reference to a function that takes an argument of the type of the measure basis, allowing the stratifier value to be determined for each member of the population.

As with any expression-valued element, the cqf-alternativeExpression extension may be used to provide an expression in an alternate language.

The path to an element A Group resource that defines the stratifier, specified this population as a valid FHIR resource path. set of characteristics.

Note that this approach can only be used for measures where the basis is of the same type as the populations (e.g. a Patient-based measure, rather than an Encounter-based measure). In addition, the referenced Group SHALL be a definitional (as opposed to an actual) group. As with any expression-valued element, the cqf-alternativeExpression extension may be used to provide an expression in an alternate language.

A value set defining the set of possible values for stratum in this stratifier. If criteria and valueSet are both present, they SHALL be consistent (i.e. criteria expressions SHALL produce stratum values that are codes in the value set referenced by this element). Note that this MAY be strictly at the code level (e.g. an Age Range code that is just the string value 01Y--05Y with the system ignored).

This element may be used to define a stratifier rather than requiring the stratifier be defined with logic. For example, a measure may reference a value set defining possible age ranges, rather than (and potentially in addition to) embedding the calculation of the age ranges into measure logic. See the MeasureStratifierAgeRangeExample value set for an example.

Indicates what units, if any, stratifier values are expected to be expressed in. This element SHOULD be specified in UCUM units or calendar units.

This element may be used to define the expected units of stratum values, when that information cannot be inferred from the calculation logic directly.

The supplemental data criteria for the measure report, specified as either the name of a valid CQL expression within a referenced library, or a valid FHIR Resource Path.

Note that supplemental data are reported as observations resources for each patient and included referenced in the evaluatedResources bundle. supplementalData element of the MeasureReport. If the supplementalData expression results in a value other than a resource, it is reported using an Observation resource, typically contained in the resulting MeasureReport. See the MeasureReport resource or and the Quality Reporting topic for more information.

An identifier for that is unique within the supplemental data. Measure allowing linkage to the equivalent item in a MeasureReport resource.

MeasureReport does not require omitted supplementalData to be included.

This ''can'' be a resource meaningful identifier (see discussion ) (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.

LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such

Indicates a meaning for the supplemental data. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing supplemental data to be correlated across measures.

An indicator of the intended usage for the supplemental data element. Supplemental data indicates the data is additional information requested to augment the measure information. Risk adjustment factor indicates the data is additional information used to calculate risk adjustment factors when applying a risk model to the measure calculation.

The human readable description of this supplemental data.

The criteria for the supplemental data. This must be is typically the name of a valid expression defined within a referenced library, and but it may also be a path to a specific data element. The criteria defines the data to be returned for this element.

As with any expression-valued element, the cqf-alternativeExpression extension may be used to provide an expression in an alternate language.

A value set defining the set of possible values for supplemental data in this element. If criteria and valueSet are both present, they SHALL be consistent (i.e. criteria expressions SHALL produce supplemental data values that are codes in the value set referenced by this element). Note that this MAY be strictly at the code level (e.g. an Age Range code that is just the string value 01Y--05Y with the system ignored).

The This element may be used to define a supplemental data element rather than requiring the element to be supplied as part defined with logic. For example, a measure may reference a value set defining possible age ranges, rather than (and potentially in addition to) embedding the calculation of the age ranges into measure response, logic. See the MeasureStratifierAgeRangeExample value set for an example.

Indicates what units, if any, supplemental data values are expected to be expressed in. This element SHOULD be specified as a valid FHIR Resource Path. in UCUM units or calendar units.

This element may be used to define the expected units of supplemental data values, when that information cannot be inferred from the calculation logic directly.