R6 Ballot (3rd Draft) FHIR CI-Build

This page is part of the FHIR Specification v6.0.0-ballot3: Release 6 Ballot (3rd Draft) (see Ballot Notes ). The current version is 5.0.0 . For a full list Continuous Integration Build of available versions, see FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions icon

14.17 14.16 Resource Measure - Content

Responsible Owner: Clinical Quality Information icon Work Group Maturity Level : 4   Trial Use Security Category : Anonymous Compartments : No defined compartments

The Measure resource provides the definition of a quality measure.

Note to Balloters: The Measure resource specifies calculation of a score using the following elements: basis, scoring, scoringUnit, scoringPrecision, improvementNotation, and improvementNotationGuidance, as well as compositeScoring and components for composite measures. The Measure resource is currently structured to allow these elements to be specified at the root, or individually on each group. The CQI Work Group is seeking implementer feedback on the following potential options: Option 1: Keep the current structure, along with the current semantics that the group level elements are overrides (e.g. scoring may be specified at the root for all groups, optionally overridden by scoring at each group) Option 2: Keep the current structure, and clarify that the calculation of a score must be specified at the root, or on each group (e.g. scoring can be specified at the root, or on all groups, but not both) Option 3: Remove the calculation elements from the root, requiring that they be specified on each group. The elements are all marked as "deprecated" in this ballot, the question is whether they should just be removed.

14.17.1 14.16.1 Scope and Usage

The Measure resource represents a structured, potentially computable, definition of a health-related measure such as a clinical quality measure, public health indicator, or population analytics measure. A quality measure is a quantitative tool to assess the performance of an individual or organization with respect to a specified process or outcome via the measurement of actions, processes, or outcomes of clinical care. Quality measures are often derived from clinical guidelines and are designed to determine whether the appropriate care has been provided given a set of clinical criteria and an evidence base.

Note that the Measure itself does not typically contain any logic; rather a Library resource is referenced that contains the logic required by the measure, and the various expression elements, such as population criteria, reference named expressions within that library (or libraries). In addition, if the Measure references multiple libraries, then any expression references within the resource must be qualified with the name of the library that contains the referenced expression. Different measure types will contain different population criteria. Some measures may contain multiple rates. Measures can also specify stratifications to subdivide the measure population and/or supplemental data to communicate additional information about a population.

The data of interest for a measure is described as a set of data requirements, and include the specific data type, as well as any constraints. If the measure is specified computably, this information may be inferred by static analysis of the logic used to defined the population criteria. This capability is exposed via the $data-requirements operation.

This resource is a definition resource from a FHIR workflow perspective - see Workflow , specifically Definition .

For a detailed discussion of how to use the Measure and MeasureReport resources, refer to the Quality Reporting topic.

14.17.2 14.16.2 Boundaries and Relationships

The Measure resource describes a specific quality measure, or population analytic, providing the structure of the measure in terms of the calculation elements (the populations involved). The Group resource is also capable of describing a population, however, the complexity involved in specifying the criteria in the general case requires the use of a high-level query language such as Clinical Quality Language (CQL). As such, the Measure resource defines only the top-level populations and references expressions for the actual criteria. These expressions are typically provided using a Library resource containing CQL or ELM expressions. In addition, the individual members of a population may be cases such as encounters or procedures and in these cases, the Group resource would be unable to represent the population characteristics accurately.

A Measure is also similar to an ObservationDefinition resource, in that it is purely definitional, it contains no actual measurements, only a description of how to calculate a particular measurement or set of measurements. Measure is different from ObservationDefinition in that Measure is intended to provide a computable specification.

A Measure is also similar to a clinical document, however a FHIR Document is specific to a particular subject, whereas the Measure resource is definitional.

Mappings from the V3 to the FHIR terminologies can be found in the Quality Measure IG icon.

14.17.3 14.16.3 References to this Resource

14.17.4 14.16.4 Resource Content

Structure

Intended jurisdiction for Use and/or publishing XD scoring Σ XD 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort | composite (deprecated, use group.scoring) Binding: Measure Scoring ( Extensible ) scoringUnit Σ XD 0..1 CodeableConcept What units? (deprecated, use group.scoringUnit) Binding: Measure Scoring Unit ( Example ) scoringPrecision Σ XD 0..1 positiveInt How many decimals (The number of decimal places to include in the score when the score is a decimal-valued result) (deprecated, use group.scoringPrecision) compositeScoring Σ XD 0..1 CodeableConcept opportunity | all-or-nothing | linear | weighted (deprecated, use group.compositeScoring) Binding: CompositeMeasureScoring ( Extensible ) type Σ XD 0..* CodeableConcept process | outcome | structure | patient-reported-outcome | composite (deprecated, use group.type) Binding: MeasureType ( Extensible ) improvementNotation Σ XD 0..1 CodeableConcept increase | decrease Binding: MeasureImprovementNotation ( Required ) improvementNotationGuidance Σ XD 0..1 markdown Explanation of improvement notation (deprecated, use group.improvementNotationGuidance) valueSet 0..1 canonical ( ValueSet ) What stratum values? unit 0..1 string What units?
Name Flags Card. Type Description & Constraints      Filter: Filters doco
. . Measure TU DomainResource A quality measure definition
+ Warning: Name should be usable as an identifier for the module by machine processing applications such as code generation
+ Rule: Stratifier SHALL be either a single criteria or a set of criteria components

Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
Interfaces Implemented: MetadataResource
. . . url Σ C 0..1 uri Canonical identifier for this measure, represented as a URI (globally unique)
+ Warning: URL should not contain | or # - these characters make processing canonical references problematic
. . . identifier Σ 0..* Identifier Additional identifier for the measure

. . . version Σ 0..1 string Business version of the measure
. . . versionAlgorithm[x] Σ 0..1 How to compare versions
Binding: Version Algorithm ( Extensible )
. . . . versionAlgorithmString string
. . . . versionAlgorithmCoding Coding
. . . name Σ C 0..1 string Name for this measure (computer friendly)
. . . title Σ T 0..1 string Name for this measure (human friendly)
. . . subtitle T 0..1 string Subordinate title of the measure
. . . status ?! Σ 1..1 code draft | active | retired | unknown
Binding: PublicationStatus ( Required )
. . . experimental Σ 0..1 boolean For testing only - never for real usage
. . . subject[x] 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
Binding: Participant Resource Types ( Extensible )
. . . . subjectCodeableConcept CodeableConcept
. . . . subjectReference Reference ( Group )
. . . basis Σ XD 0..1 code Population basis (deprecated, use group.basis) Binding: All FHIR Types ( Required ) date Σ 0..1 dateTime Date last changed
. . . publisher Σ T 0..1 string Name of the publisher/steward (organization or individual)
. . . contact Σ 0..* ContactDetail Contact details for the publisher

. . . description Σ T 0..1 markdown Natural language description of the measure
. . . useContext Σ 0..* UsageContext The context that the content is intended to support

. . . jurisdiction Σ XD 0..* CodeableConcept Jurisdiction of the authority that maintains the measure (if applicable)
Binding: Jurisdiction ValueSet icon ( Extensible )

. . . purpose T 0..1 markdown Why this measure is defined
. . . usage T 0..1 markdown Describes the clinical usage of the measure
. . . copyright T 0..1 markdown Notice about intellectual property ownership, can include restrictions on use
. . . copyrightLabel T 0..1 string Copyright holder and year(s)
. . . approvalDate 0..1 date When the measure was approved by publisher
. . . lastReviewDate 0..1 date When the measure was last reviewed by the publisher
. . . effectivePeriod Σ 0..1 Period When the measure is expected to be used
. . . reportingFrequency 0..1 Quantity The frequency in which this measure should be reported (e.g. 1 '/a' - yearly, 4 '/a' - quarterly)
Binding: Frequency Unit ( Extensible )
. . . topic 0..* CodeableConcept The category of the measure, such as Education, Treatment, Assessment, etc
Binding: Definition Topic ( Example )

. . . author 0..* ContactDetail Who authored the content

. . . editor 0..* ContactDetail Who edited the content

. . . reviewer 0..* ContactDetail Who reviewed the content

. . . endorser 0..* ContactDetail Who endorsed the content

. . . relatedArtifact C 0..* RelatedArtifact Additional documentation, citations, etc
+ Warning: Dependencies and components of a Measure should reference a resource

. . . library 0..* canonical ( Library ) Logic used by the measure

. . . disclaimer Σ 0..1 markdown Disclaimer for use of the measure or its referenced content
. . . riskAdjustment Σ 0..1 markdown How risk adjustment is applied for this measure
. . . rateAggregation Σ 0..1 markdown How is rate aggregation performed for this measure
. . . rationale Σ 0..1 markdown Justification for the measure in terms of impact, gap in care, and evidence
. . . clinicalRecommendationStatement Σ 0..1 markdown Summary of clinical guidelines
. . . term 0..* BackboneElement Defined terms used in the measure documentation

. . . . code 0..1 CodeableConcept What term?
Binding: Measure Definition Example ( Example )
. . . . definition 0..1 markdown Meaning of the term
. . . guidance Σ XD 0..1 markdown Additional guidance for implementers (deprecated)
. . . group C 0..* BackboneElement Population criteria group

. . . . linkId C 0..1 string Unique id for group in measure
+ Warning: Link ids should be 255 characters or less
. . . . title 0..1 string Title of the group. This title is expected in the corresponding MeasureReport.group.title
.... code 0..1 CodeableConcept Meaning of the group
Binding: Measure Group Example ( Example )
. . . . description 0..1 markdown Summary description
. . . . type Σ 0..* CodeableConcept process | outcome | structure | patient-reported-outcome
Binding: MeasureType icon ( Extensible )

. . . . subject[x] 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
Binding: Participant Resource Types ( Extensible )
. . . . . subjectCodeableConcept CodeableConcept
. . . . . subjectReference Reference ( Group )
. . . . basis Σ 0..1 code Population basis
Binding: All FHIR Types ( Required )
. . . . basisRequirement C 0..* DataRequirement Population basis requirements
+ Rule: Basis requirements SHALL have a type, MAY have profile and codeFilter elements, and SHALL NOT specify dateFilter, valueFilter, limit, or sort

. . . . scoring Σ 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort | composite
Binding: Measure Scoring icon ( Extensible )
. . . . scoringUnit Σ 0..1 CodeableConcept What units?
Binding: Measure Scoring Unit ( Example )
. . . . scoringPrecision Σ 0..1 positiveInt How many decimals (The number of decimal places to include in the score when the score is a decimal-valued result)
. . . . compositeScoring Σ 0..1 CodeableConcept opportunity | all-or-nothing | linear | weighted
Binding: CompositeMeasureScoring icon ( Extensible )
. . . . component 0..* BackboneElement A component of a composite measure

. . . . . measure 0..1 canonical () What measure?
. . . . . groupId 0..1 string What group?
. . . . . weight 0..1 decimal What weight?
. . . . rateAggregation Σ 0..1 markdown How is rate aggregation performed for this measure
. . . . improvementNotation Σ 0..1 CodeableConcept increase | decrease
Binding: MeasureImprovementNotation icon ( Extensible )
. . . . improvementNotationGuidance Σ 0..1 markdown Explanation of improvement notation
. . . . library 0..* canonical ( Library ) Logic used by the measure group

. . . . population 0..* BackboneElement Population criteria

. . . . . linkId C 0..1 string Unique id for population in measure
+ Warning: Link ids should be 255 characters or less
. . . . . title 0..1 string Title of the group's population. This title is expected in the corresponding MeasureReport.group.population.title
..... code 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType icon ( Extensible )
. . . . . description 0..1 markdown The human readable description of this population criteria
. . . . . criteria 0..1 Expression The criteria that defines this population
. . . . . groupDefinition 0..1 Reference ( Group ) A group resource that defines this population
. . . . . inputPopulationId 0..1 string Which population
. . . . . aggregateMethod 0..1 CodeableConcept Aggregation method for a measure score (e.g. sum, average, median, minimum, maximum, count)
Binding: Measure Aggregate Method icon ( Extensible )
. . . . stratifier C 0..* BackboneElement Stratifier criteria for the measure

. . . . . linkId C 0..1 string Unique id for stratifier in measure
+ Warning: Link ids should be 255 characters or less
. . . . . title 0..1 string Title of a group's stratifier. This title is expected in the corresponding MeasureReport.group.title
. . . . . code C 0..1 CodeableConcept Meaning of the stratifier
Binding: Measure Stratifier Example ( Example )
. . . . . description C 0..1 markdown The human readable description of this stratifier
. . . . . criteria C 0..1 Expression How the measure should be stratified
. . . . . groupDefinition 0..1 Reference ( Group ) A group resource that defines this population
. . . . . component C 0..* BackboneElement Stratifier criteria component for the measure

. . . . . . linkId C 0..1 string Unique id for stratifier component in measure
+ Warning: Link ids should be 255 characters or less
. . . . . . code 0..1 CodeableConcept Meaning of the stratifier component
Binding: Measure Stratifier Example ( Example )
. . . . . . description 0..1 markdown The human readable description of this stratifier component
. . . . . . criteria 0..1 Expression Component of how the measure should be stratified
. . . . . . groupDefinition 0..1 Reference ( Group ) A group resource that defines this population
. . . . . . valueSet 0..1 canonical ( ValueSet ) What stratum values?
. . . . . . unit 0..1 string What units?
. . . supplementalData 0..* BackboneElement What other data should be reported with the measure

. . . . linkId C 0..1 string Unique id for supplementalData in measure
+ Warning: Link ids should be 255 characters or less
. . . . code 0..1 CodeableConcept Meaning of the supplemental data
Binding: Measure Supplemental Data Example ( Example )
. . . . usage 0..* CodeableConcept supplemental-data | risk-adjustment-factor
Binding: MeasureDataUsage icon ( Extensible )

. . . . description 0..1 markdown The human readable description of this supplemental data
. . . . criteria 1..1 Expression Expression describing additional data to be reported
. . . . valueSet 0..1 canonical ( ValueSet ) What supplemental data values?
. . . . unit 0..1 string What units?

doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

Measure ( DomainResource ) + MetadataResource An absolute URI that is used to identify this measure when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which an authoritative instance of this measure is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the measure is stored on different servers url : uri [0..1] 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 identifier : Identifier [0..*] 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 version : string [0..1] Indicates the mechanism used to compare versions to determine which is more current versionAlgorithm[x] : DataType [0..1] « string | Coding ; null (Strength=Extensible) VersionAlgorithm + » 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 name : string [0..1] « This element has or is affected by some invariants C » A short, descriptive, user-friendly title for the measure title : string [0..1] An explanatory or alternate title for the measure giving additional information about its content subtitle : string [0..1] The status of this measure. Enables tracking the life-cycle of the content (this element modifies the meaning of other elements) status : code [1..1] « null (Strength=Required) PublicationStatus ! » A Boolean value to indicate that this measure is authored for testing purposes (or education/evaluation/marketing) and no version of this resource will ever be intended for genuine usage experimental : boolean [0..1] 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 subject[x] : DataType [0..1] « CodeableConcept | Reference ( Group ); null (Strength=Extensible) ParticipantResourceTypes + » 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 a population basis of Encounter, and the population criteria all return lists of Encounters basis : code [0..1] « null (Strength=Required) FHIRTypes ! » The date (and optionally time) when the measure was last significantly changed. The date must change 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 date : dateTime [0..1] The name of the organization or individual responsible for the release and ongoing maintenance of the measure publisher : string [0..1] Contact details to assist a user in finding and communicating with the publisher contact : ContactDetail [0..*] A free text natural language description of the measure from a consumer's perspective description : markdown [0..1] 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 useContext : UsageContext [0..*] A legal or geographic region in which the measure authority that maintains the resource is intended to be used 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 jurisdiction : CodeableConcept [0..*] « null (Strength=Extensible) JurisdictionValueSet + » Explanation of why this measure is needed and why it has been designed as it has purpose : markdown [0..1] A detailed description, from a clinical perspective, of how the measure is used usage : markdown [0..1] A copyright statement relating to the measure and/or its contents. Copyright statements are generally legal notices of intellectual property ownership and can include restrictions on the use and publishing of the measure copyright : markdown [0..1] A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. restricted. (e.g. 'All rights reserved', 'Some rights reserved') copyrightLabel : string [0..1] The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage approvalDate : date [0..1] The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date lastReviewDate : date [0..1] The period during which the measure content was or is planned to be in active use effectivePeriod : Period [0..1] The frequency that this measure should be reported, usually specified by the program it is being submitted to reportingFrequency : Quantity [0..1] « null (Strength=Extensible) FrequencyUnit + » Descriptive topics related to the content of the measure. Topics provide a high-level categorization grouping types of measures that can be useful for filtering and searching topic : CodeableConcept [0..*] « null (Strength=Example) DefinitionTopic ?? » An individiual or organization primarily involved in the creation and maintenance of the content author : ContactDetail [0..*] An individual or organization primarily responsible for internal coherence of the content editor : ContactDetail [0..*] An individual or organization asserted by the publisher to be primarily responsible for review of some aspect of the content reviewer : ContactDetail [0..*] An individual or organization asserted by the publisher to be responsible for officially endorsing the content for use in some setting endorser : ContactDetail [0..*] Related artifacts such as additional documentation, justification, or bibliographic references relatedArtifact : RelatedArtifact [0..*] A reference to a Library resource containing the formal logic used by the measure library : canonical [0..*] « Library » Notices and disclaimers regarding the use of the measure or related to intellectual property (such as code systems) referenced by the measure disclaimer : markdown [0..1] Deprecated, use group.scoring. 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 scoring : CodeableConcept [0..1] « null (Strength=Extensible) MeasureScoring + » Deprecated, use group.scoringUnit. Defines the expected units of measure for the measure score. This element SHOULD be specified as a UCUM unit scoringUnit : CodeableConcept [0..1] « null (Strength=Example) MeasureScoringUnit ?? » Deprecated, use group.scoringPrecision) When the score is a decimal value this should be used to specify the expected minimum number of digits after the decimal point to use for the precision of 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 scoringPrecision : positiveInt [0..1] Deprecated, use group.compositeScoring. If this is a composite measure, the scoring method used to combine the component measures to determine the composite score compositeScoring : CodeableConcept [0..1] « null (Strength=Extensible) CompositeMeasureScoring + » Deprecated, use group.type. 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 type : CodeableConcept [0..*] « null (Strength=Extensible) MeasureType + » 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 riskAdjustment : markdown [0..1] Describes how to combine the information calculated, based on logic in each of several populations, into one summarized result rateAggregation : markdown [0..1] Provides a detailed justification of the need for the measure including statements pertaining to importance criterion: impact, gap in care, and evidence rationale : markdown [0..1] Provides a summary of relevant clinical guidelines or other clinical recommendations supporting the measure clinicalRecommendationStatement : markdown [0..1] Deprecated, use group.improvementNotation. 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 within a range) improvementNotation : CodeableConcept [0..1] « null (Strength=Required) MeasureImprovementNotation ! » Deprecated, use group.improvementNotationGuidance. Narrative text to explain the improvement notation and how to interpret it improvementNotationGuidance : markdown [0..1] Additional guidance for the measure including how it can be used in a clinical context, and the intent of the measure guidance : markdown [0..1] Term A codeable representation of the defined term code : CodeableConcept [0..1] « null (Strength=Example) MeasureDefinitionExample ?? » Provides a definition for the term as used within the measure definition : markdown [0..1] Group An identifier that is unique within the Measure allowing linkage to the equivalent item in a MeasureReport resource linkId : string [0..1] Indicates the title for the group title : string [0..1] 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 code : CodeableConcept [0..1] « null (Strength=Example) MeasureGroupExample ?? » The human readable description of this population group description : markdown [0..1] 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 type : CodeableConcept [0..*] « null (Strength=Extensible) MeasureType + » The intended subjects for the measure. If this element is not provided, the root subject there is used to determine no subject context (i.e. population criteria are evaluated from the group perspective of the entire system, rather than from the perspective of a particular subject) subject[x] : DataType [0..1] « CodeableConcept | Reference ( Group ); null (Strength=Extensible) ParticipantResourceTypes + » 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 a population basis of Encounter, and the population criteria all return lists of Encounters basis : code [0..1] « null (Strength=Required) FHIRTypes ! » 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 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) basisRequirement : DataRequirement [0..*] 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 scoring : CodeableConcept [0..1] « null (Strength=Extensible) MeasureScoring + » Defines the expected units of measure for the measure score. This element SHOULD be specified as a UCUM unit scoringUnit : CodeableConcept [0..1] « null (Strength=Example) MeasureScoringUnit ?? » When the score is a decimal value this should be used to specify the expected minimum number of digits after the decimal point to use for the precision of 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 scoringPrecision : positiveInt [0..1] If this is a composite measure, the scoring method used to combine the component measures to determine the composite score compositeScoring : CodeableConcept [0..1] « null (Strength=Extensible) CompositeMeasureScoring + » Describes how to combine the information calculated, based on logic in each of several populations, into one summarized result rateAggregation : markdown [0..1] 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 within a range). Exercise caution when using any values besides increase or decrease for improvementNotation improvementNotation : CodeableConcept [0..1] « null (Strength=Extensible) MeasureImprovementNotation + » Narrative text to explain the improvement notation and how to interpret it improvementNotationGuidance : markdown [0..1] A reference to a Library resource containing the formal logic used by the measure group library : canonical [0..*] « Library » Component The measure that contains the definition of the component calculation measure : canonical [0..1] « » Specifies the id of a particular group within the measure referenced by the related artifact resource groupId : string [0..1] What is the weight of the contribution of this measure to the overall score weight : decimal [0..1] Population An identifier that is unique within the Measure allowing linkage to the equivalent population in a MeasureReport resource linkId : string [0..1] Indicates the title for the group's population title : string [0..1] The type of population criteria code : CodeableConcept [0..1] « null (Strength=Extensible) MeasurePopulationType + » The human readable description of this population criteria description : markdown [0..1] An expression that specifies the criteria for the population, typically the name of an expression in a library criteria : Expression [0..1] A Group resource that defines this population as a set of characteristics groupDefinition : Reference [0..1] « Group » The id of a population element in this 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 inputPopulationId : string [0..1] 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 information must be specified to ensure correct calculation aggregateMethod : CodeableConcept [0..1] « null (Strength=Extensible) MeasureAggregateMethod + » Stratifier An identifier that is unique within the Measure allowing linkage to the equivalent item in a MeasureReport resource linkId : string [0..1] Indicates the title for the stratifier of the group title : string [0..1] 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 code : CodeableConcept [0..1] « null (Strength=Example) MeasureStratifierExample ?? » « This element has or is affected by some invariants C » The human readable description of this stratifier criteria description : markdown [0..1] « This element has or is affected by some invariants C » An expression that specifies the criteria a criteria-based stratifier for the stratifier. measure. This is typically the name of an expression defined within a referenced library, but it may also be a path to a stratifier element and SHALL use the same basis as other population criteria for the population group criteria : Expression [0..1] « This element has or is affected by some invariants C » A Group resource that defines this population as a set of characteristics groupDefinition : Reference [0..1] « Group » 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) valueSet : canonical [0..1] « ValueSet » Indicates what units, if any, stratifier values are expected to be expressed in. This element SHOULD be specified in UCUM units or calendar units unit : string [0..1] Component An identifier that is unique within the Measure allowing linkage to the equivalent item in a MeasureReport resource linkId : string [0..1] Indicates a 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 code : CodeableConcept [0..1] « null (Strength=Example) MeasureStratifierExample ?? » The human readable description of this stratifier criteria component description : markdown [0..1] An expression that specifies returns the criteria for value of this component of the stratifier. stratifier for a member of the population. This is typically the name of an expression defined within a referenced library, but it may also be a path to a stratifier element 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 criteria : Expression [0..1] A Group resource that defines this population as a set of characteristics groupDefinition : Reference [0..1] « Group » 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) valueSet : canonical [0..1] « ValueSet » Indicates what units, if any, stratifier values are expected to be expressed in. This element SHOULD be specified in UCUM units or calendar units unit : string [0..1] SupplementalData An identifier that is unique within the Measure allowing linkage to the equivalent item in a MeasureReport resource linkId : string [0..1] 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 code : CodeableConcept [0..1] « null (Strength=Example) MeasureSupplementalDataExample ?? » 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 usage : CodeableConcept [0..*] « null (Strength=Extensible) MeasureDataUsage + » The human readable description of this supplemental data description : markdown [0..1] The criteria for the supplemental data. This is typically the name of a valid expression defined within a referenced library, but it may also be a path to a specific data element. The criteria defines the data to be returned for this element criteria : Expression [1..1] 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) valueSet : canonical [0..1] « ValueSet » Indicates what units, if any, supplemental data values are expected to be expressed in. This element SHOULD be specified in UCUM units or calendar units unit : string [0..1] Provides a description of an individual term used within the measure term [0..*] If this is a composite measure, a component of the composite component [0..*] A population criteria for the measure population [0..*] A component of the a value-based stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library or a valid FHIR Resource Path component [0..*] The A stratifier criteria for the measure report, measure, specified as either the name of a valid CQL expression defined within a referenced library criteria expression, or a valid FHIR Resource Path set of components that define value-based stratifier expressions stratifier [0..*] A group of population criteria for the measure group [0..*] 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 supplementalData [0..*]

XML Template 

<Measure xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <url value="[uri]"/><!-- 0..1 Canonical identifier for this measure, represented as a URI (globally unique) -->
 <identifier><!-- 0..* Identifier Additional identifier for the measure --></identifier>
 <version value="[string]"/><!-- 0..1 Business version of the measure -->
 <versionAlgorithm[x]><!-- 0..1 string|Coding How to compare versions --></versionAlgorithm[x]>
 <name value="[string]"/><!-- I 0..1 Name for this measure (computer friendly) -->
 <title value="[string]"/><!-- 0..1 Name for this measure (human friendly) -->
 <subtitle value="[string]"/><!-- 0..1 Subordinate title of the measure -->
 <status value="[code]"/><!-- 1..1 draft | active | retired | unknown -->
 <experimental value="[boolean]"/><!-- 0..1 For testing only - never for real usage -->
 <subject[x]><!-- 0..1 CodeableConcept|Reference(Group) E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device --></subject[x]>
 <

 <date value="[dateTime]"/><!-- 0..1 Date last changed -->
 <publisher value="[string]"/><!-- 0..1 Name of the publisher/steward (organization or individual) -->
 <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact>
 <description value="[markdown]"/><!-- 0..1 Natural language description of the measure -->
 <useContext><!-- 0..* UsageContext The context that the content is intended to support --></useContext>
 <</jurisdiction>

 <jurisdiction><!-- 0..* CodeableConcept Jurisdiction of the authority that maintains the measure (if applicable) icon --></jurisdiction>

 <purpose value="[markdown]"/><!-- 0..1 Why this measure is defined -->
 <usage value="[markdown]"/><!-- 0..1 Describes the clinical usage of the measure -->
 <
 <

 <copyright value="[markdown]"/><!-- 0..1 Notice about intellectual property ownership, can include restrictions on use -->
 <copyrightLabel value="[string]"/><!-- 0..1 Copyright holder and year(s) -->

 <approvalDate value="[date]"/><!-- 0..1 When the measure was approved by publisher -->
 <lastReviewDate value="[date]"/><!-- 0..1 When the measure was last reviewed by the publisher -->
 <effectivePeriod><!-- 0..1 Period When the measure is expected to be used --></effectivePeriod>
 <</reportingFrequency>

 <reportingFrequency><!-- 0..1 Quantity The frequency in which this measure should be reported (e.g. 1 '/a' - yearly, 4 '/a' - quarterly) --></reportingFrequency>

 <topic><!-- 0..* CodeableConcept The category of the measure, such as Education, Treatment, Assessment, etc --></topic>
 <author><!-- 0..* ContactDetail Who authored the content --></author>
 <editor><!-- 0..* ContactDetail Who edited the content --></editor>
 <reviewer><!-- 0..* ContactDetail Who reviewed the content --></reviewer>
 <endorser><!-- 0..* ContactDetail Who endorsed the content --></endorser>
 <relatedArtifact><!-- 0..* RelatedArtifact Additional documentation, citations, etc --></relatedArtifact>
 <library><!-- 0..* canonical(Library) Logic used by the measure --></library>
 <disclaimer value="[markdown]"/><!-- 0..1 Disclaimer for use of the measure or its referenced content -->
 <</scoring>
 <</scoringUnit>
 <
 <</compositeScoring>
 <</type>

 <riskAdjustment value="[markdown]"/><!-- 0..1 How risk adjustment is applied for this measure -->
 <rateAggregation value="[markdown]"/><!-- 0..1 How is rate aggregation performed for this measure -->
 <rationale value="[markdown]"/><!-- 0..1 Justification for the measure in terms of impact, gap in care, and evidence -->
 <clinicalRecommendationStatement value="[markdown]"/><!-- 0..1 Summary of clinical guidelines -->
 <</improvementNotation>
 <

 <term>  <!-- 0..* Defined terms used in the measure documentation -->
  <code><!-- 0..1 CodeableConcept What term? --></code>
  <definition value="[markdown]"/><!-- 0..1 Meaning of the term -->
 </term>
 <guidance value="[markdown]"/><!-- 0..1 Additional guidance for implementers (deprecated) -->
 <group>  <!-- I 0..* Population criteria group -->
  <linkId value="[string]"/><!-- 0..1 Unique id for group in measure -->
  <title value="[string]"/><!-- 0..1 Title of the group. This title is expected in the corresponding MeasureReport.group.title -->

  <code><!-- 0..1 CodeableConcept Meaning of the group --></code>
  <description value="[markdown]"/><!-- 0..1 Summary description -->
  <</type>
  <</subject[x]>

  <type><!-- 0..* CodeableConcept process | outcome | structure | patient-reported-outcome icon --></type>
  <subject[x]><!-- 0..1 CodeableConcept|Reference(Group) E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device --></subject[x]>

  <basis value="[code]"/><!-- 0..1 Population basis -->
  <</scoring>

  <basisRequirement><!-- 0..* DataRequirement Population basis requirements --></basisRequirement>
  <scoring><!-- 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort | composite icon --></scoring>

  <scoringUnit><!-- 0..1 CodeableConcept What units? --></scoringUnit>
  <scoringPrecision value="[positiveInt]"/><!-- 0..1 How many decimals (The number of decimal places to include in the score when the score is a decimal-valued result) -->
  <</compositeScoring>

  <compositeScoring><!-- 0..1 CodeableConcept opportunity | all-or-nothing | linear | weighted icon --></compositeScoring>

  <component>  <!-- 0..* A component of a composite measure -->
   <measure value="[canonical]"/><!-- 0..1 What measure? -->
   <groupId value="[string]"/><!-- 0..1 What group? -->
   <weight value="[decimal]"/><!-- 0..1 What weight? -->
  </component>
  <rateAggregation value="[markdown]"/><!-- 0..1 How is rate aggregation performed for this measure -->
  <</improvementNotation>

  <improvementNotation><!-- 0..1 CodeableConcept increase | decrease icon --></improvementNotation>

  <improvementNotationGuidance value="[markdown]"/><!-- 0..1 Explanation of improvement notation -->
  <library><!-- 0..* canonical(Library) Logic used by the measure group --></library>
  <population>  <!-- 0..* Population criteria -->
   <linkId value="[string]"/><!-- 0..1 Unique id for population in measure -->
   <</code>

   <title value="[string]"/><!-- 0..1 Title of the group's population. This title is expected in the corresponding MeasureReport.group.population.title -->
   <code><!-- 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation icon --></code>

   <description value="[markdown]"/><!-- 0..1 The human readable description of this population criteria -->
   <criteria><!-- 0..1 Expression The criteria that defines this population --></criteria>
   <groupDefinition><!-- 0..1 Reference(Group) A group resource that defines this population --></groupDefinition>
   <inputPopulationId value="[string]"/><!-- 0..1 Which population -->
   <</aggregateMethod>

   <aggregateMethod><!-- 0..1 CodeableConcept Aggregation method for a measure score (e.g. sum, average, median, minimum, maximum, count) icon --></aggregateMethod>

  </population>
  <

  <stratifier>  <!-- I 0..* Stratifier criteria for the measure -->

   <linkId value="[string]"/><!-- 0..1 Unique id for stratifier in measure -->
   <title value="[string]"/><!-- 0..1 Title of a group's stratifier. This title is expected in the corresponding MeasureReport.group.title -->

   <code><!-- I 0..1 CodeableConcept Meaning of the stratifier --></code>
   <description value="[markdown]"/><!-- I 0..1 The human readable description of this stratifier -->
   <</criteria>

   <criteria><!-- I 0..1 Expression How the measure should be stratified --></criteria>

   <groupDefinition><!-- 0..1 Reference(Group) A group resource that defines this population --></groupDefinition>
   <</valueSet>
   <
   <

   <component>  <!-- I 0..* Stratifier criteria component for the measure -->

    <linkId value="[string]"/><!-- 0..1 Unique id for stratifier component in measure -->
    <code><!-- 0..1 CodeableConcept Meaning of the stratifier component --></code>
    <description value="[markdown]"/><!-- 0..1 The human readable description of this stratifier component -->
    <</criteria>

    <criteria><!-- 0..1 Expression Component of how the measure should be stratified --></criteria>

    <groupDefinition><!-- 0..1 Reference(Group) A group resource that defines this population --></groupDefinition>
    <valueSet><!-- 0..1 canonical(ValueSet) What stratum values? --></valueSet>
    <unit value="[string]"/><!-- 0..1 What units? -->
   </component>
  </stratifier>
 </group>
 <supplementalData>  <!-- 0..* What other data should be reported with the measure -->
  <linkId value="[string]"/><!-- 0..1 Unique id for supplementalData in measure -->
  <code><!-- 0..1 CodeableConcept Meaning of the supplemental data --></code>
  <</usage>

  <usage><!-- 0..* CodeableConcept supplemental-data | risk-adjustment-factor icon --></usage>

  <description value="[markdown]"/><!-- 0..1 The human readable description of this supplemental data -->
  <criteria><!-- 1..1 Expression Expression describing additional data to be reported --></criteria>
  <valueSet><!-- 0..1 canonical(ValueSet) What supplemental data values? --></valueSet>
  <unit value="[string]"/><!-- 0..1 What units? -->
 </supplementalData>
</Measure>

JSON Template 

{doco
  "resourceType" : "Measure",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "url" : "<uri>", // Canonical identifier for this measure, represented as a URI (globally unique)
  "identifier" : [{ Identifier }], // Additional identifier for the measure
  "version" : "<string>", // Business version of the measure
  // versionAlgorithm[x]: How to compare versions. One of these 2:
  "versionAlgorithmString" : "<string>",
  "versionAlgorithmCoding" : { Coding },
  "name" : "<string>", // I Name for this measure (computer friendly)
  "title" : "<string>", // Name for this measure (human friendly)
  "subtitle" : "<string>", // Subordinate title of the measure
  "status" : "<code>", // R!  draft | active | retired | unknown
  "experimental" : <boolean>, // For testing only - never for real usage
  // subject[x]: E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2:
  "subjectCodeableConcept" : { CodeableConcept },
  "subjectReference" : { Reference(Group) },
  "

  "date" : "<dateTime>", // Date last changed
  "publisher" : "<string>", // Name of the publisher/steward (organization or individual)
  "contact" : [{ ContactDetail }], // Contact details for the publisher
  "description" : "<markdown>", // Natural language description of the measure
  "useContext" : [{ UsageContext }], // The context that the content is intended to support
  "

  "jurisdiction" : [{ CodeableConcept }], // Jurisdiction of the authority that maintains the measure (if applicable) icon

  "purpose" : "<markdown>", // Why this measure is defined
  "usage" : "<markdown>", // Describes the clinical usage of the measure
  "
  "

  "copyright" : "<markdown>", // Notice about intellectual property ownership, can include restrictions on use
  "copyrightLabel" : "<string>", // Copyright holder and year(s)

  "approvalDate" : "<date>", // When the measure was approved by publisher
  "lastReviewDate" : "<date>", // When the measure was last reviewed by the publisher
  "effectivePeriod" : { Period }, // When the measure is expected to be used
  "

  "reportingFrequency" : { Quantity }, // The frequency in which this measure should be reported (e.g. 1 '/a' - yearly, 4 '/a' - quarterly)

  "topic" : [{ CodeableConcept }], // The category of the measure, such as Education, Treatment, Assessment, etc
  "author" : [{ ContactDetail }], // Who authored the content
  "editor" : [{ ContactDetail }], // Who edited the content
  "reviewer" : [{ ContactDetail }], // Who reviewed the content
  "endorser" : [{ ContactDetail }], // Who endorsed the content
  "relatedArtifact" : [{ RelatedArtifact }], // Additional documentation, citations, etc
  "library" : ["<canonical(Library)>"], // Logic used by the measure
  "disclaimer" : "<markdown>", // Disclaimer for use of the measure or its referenced content
  "
  "
  "
  "
  "

  "riskAdjustment" : "<markdown>", // How risk adjustment is applied for this measure
  "rateAggregation" : "<markdown>", // How is rate aggregation performed for this measure
  "rationale" : "<markdown>", // Justification for the measure in terms of impact, gap in care, and evidence
  "clinicalRecommendationStatement" : "<markdown>", // Summary of clinical guidelines
  "
  "

  "term" : [{ // Defined terms used in the measure documentation
    "code" : { CodeableConcept }, // What term?
    "definition" : "<markdown>" // Meaning of the term
  }],
  "guidance" : "<markdown>", // Additional guidance for implementers (deprecated)
  "group" : [{ // I Population criteria group
    "linkId" : "<string>", // Unique id for group in measure
    "title" : "<string>", // Title of the group. This title is expected in the corresponding MeasureReport.group.title

    "code" : { CodeableConcept }, // Meaning of the group
    "description" : "<markdown>", // Summary description
    "

    "type" : [{ CodeableConcept }], // process | outcome | structure | patient-reported-outcome icon

    // subject[x]: E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2:
    " },
    " },

    "subjectCodeableConcept" : { CodeableConcept },
    "subjectReference" : { Reference(Group) },

    "basis" : "<code>", // Population basis
    "

    "basisRequirement" : [{ DataRequirement }], // Population basis requirements
    "scoring" : { CodeableConcept }, // proportion | ratio | continuous-variable | cohort | composite icon

    "scoringUnit" : { CodeableConcept }, // What units?
    "scoringPrecision" : "<positiveInt>", // How many decimals (The number of decimal places to include in the score when the score is a decimal-valued result)
    "

    "compositeScoring" : { CodeableConcept }, // opportunity | all-or-nothing | linear | weighted icon

    "component" : [{ // A component of a composite measure
      "measure" : "<canonical>", // What measure?
      "groupId" : "<string>", // What group?
      "weight" : <decimal> // What weight?
    }],
    "rateAggregation" : "<markdown>", // How is rate aggregation performed for this measure
    "

    "improvementNotation" : { CodeableConcept }, // increase | decrease icon

    "improvementNotationGuidance" : "<markdown>", // Explanation of improvement notation
    "library" : ["<canonical(Library)>"], // Logic used by the measure group
    "population" : [{ // Population criteria
      "linkId" : "<string>", // Unique id for population in measure
      "

      "title" : "<string>", // Title of the group's population. This title is expected in the corresponding MeasureReport.group.population.title
      "code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation icon

      "description" : "<markdown>", // The human readable description of this population criteria
      "criteria" : { Expression }, // The criteria that defines this population
      "groupDefinition" : { Reference(Group) }, // A group resource that defines this population
      "inputPopulationId" : "<string>", // Which population
      "

      "aggregateMethod" : { CodeableConcept } // Aggregation method for a measure score (e.g. sum, average, median, minimum, maximum, count) icon

    }],
    "

    "stratifier" : [{ // I Stratifier criteria for the measure

      "linkId" : "<string>", // Unique id for stratifier in measure
      "title" : "<string>", // Title of a group's stratifier. This title is expected in the corresponding MeasureReport.group.title

      "code" : { CodeableConcept }, // I Meaning of the stratifier
      "description" : "<markdown>", // I The human readable description of this stratifier
      "

      "criteria" : { Expression }, // I How the measure should be stratified

      "groupDefinition" : { Reference(Group) }, // A group resource that defines this population
      "
      "
      "

      "component" : [{ // I Stratifier criteria component for the measure

        "linkId" : "<string>", // Unique id for stratifier component in measure
        "code" : { CodeableConcept }, // Meaning of the stratifier component
        "description" : "<markdown>", // The human readable description of this stratifier component
        "

        "criteria" : { Expression }, // Component of how the measure should be stratified

        "groupDefinition" : { Reference(Group) }, // A group resource that defines this population
        "valueSet" : "<canonical(ValueSet)>", // What stratum values?
        "unit" : "<string>" // What units?
      }]
    }]
  }],
  "supplementalData" : [{ // What other data should be reported with the measure
    "linkId" : "<string>", // Unique id for supplementalData in measure
    "code" : { CodeableConcept }, // Meaning of the supplemental data
    "

    "usage" : [{ CodeableConcept }], // supplemental-data | risk-adjustment-factor icon

    "description" : "<markdown>", // The human readable description of this supplemental data
    "criteria" : { Expression }, // R!  Expression describing additional data to be reported
    "valueSet" : "<canonical(ValueSet)>", // What supplemental data values?
    "unit" : "<string>" // What units?
  }]
}

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Measure;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from 
  # from 

  # from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language
  # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension

  fhir:url [ uri ] ; # 0..1 Canonical identifier for this measure, represented as a URI (globally unique)
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Additional identifier for the measure
  fhir:version [ string ] ; # 0..1 Business version of the measure
  # versionAlgorithm[x] : 0..1 How to compare versions. One of these 2
    fhir: ]

    fhir:versionAlgorithm [  a fhir:String ; string ]

    fhir:versionAlgorithm [  a fhir:Coding ; Coding ]
  fhir:name [ string ] ; # 0..1 I Name for this measure (computer friendly)
  fhir:title [ string ] ; # 0..1 Name for this measure (human friendly)
  fhir:subtitle [ string ] ; # 0..1 Subordinate title of the measure
  fhir:status [ code ] ; # 1..1 draft | active | retired | unknown
  fhir:experimental [ boolean ] ; # 0..1 For testing only - never for real usage
  # subject[x] : 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2
    fhir:subject [  a fhir:CodeableConcept ; CodeableConcept ]
    fhir:subject [  a fhir:Reference ; Reference(Group) ]
  fhir:

  fhir:date [ dateTime ] ; # 0..1 Date last changed
  fhir:publisher [ string ] ; # 0..1 Name of the publisher/steward (organization or individual)
  fhir:contact  ( [ ContactDetail ] ... ) ; # 0..* Contact details for the publisher
  fhir:description [ markdown ] ; # 0..1 Natural language description of the measure
  fhir:useContext  ( [ UsageContext ] ... ) ; # 0..* The context that the content is intended to support
  fhir:

  fhir:jurisdiction  ( [ CodeableConcept ] ... ) ; # 0..* Jurisdiction of the authority that maintains the measure (if applicable)

  fhir:purpose [ markdown ] ; # 0..1 Why this measure is defined
  fhir:usage [ markdown ] ; # 0..1 Describes the clinical usage of the measure
  fhir:
  fhir:

  fhir:copyright [ markdown ] ; # 0..1 Notice about intellectual property ownership, can include restrictions on use
  fhir:copyrightLabel [ string ] ; # 0..1 Copyright holder and year(s)

  fhir:approvalDate [ date ] ; # 0..1 When the measure was approved by publisher
  fhir:lastReviewDate [ date ] ; # 0..1 When the measure was last reviewed by the publisher
  fhir:effectivePeriod [ Period ] ; # 0..1 When the measure is expected to be used
  fhir:reportingFrequency [ Quantity ] ; # 0..1 The frequency in which this measure should be reported (e.g. 1 '/a' - yearly, 4 '/a' - quarterly)
  fhir:topic  ( [ CodeableConcept ] ... ) ; # 0..* The category of the measure, such as Education, Treatment, Assessment, etc
  fhir:author  ( [ ContactDetail ] ... ) ; # 0..* Who authored the content
  fhir:editor  ( [ ContactDetail ] ... ) ; # 0..* Who edited the content
  fhir:reviewer  ( [ ContactDetail ] ... ) ; # 0..* Who reviewed the content
  fhir:endorser  ( [ ContactDetail ] ... ) ; # 0..* Who endorsed the content
  fhir:relatedArtifact  ( [ RelatedArtifact ] ... ) ; # 0..* Additional documentation, citations, etc
  fhir:library  ( [ canonical(Library) ] ... ) ; # 0..* Logic used by the measure
  fhir:disclaimer [ markdown ] ; # 0..1 Disclaimer for use of the measure or its referenced content
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:

  fhir:riskAdjustment [ markdown ] ; # 0..1 How risk adjustment is applied for this measure
  fhir:rateAggregation [ markdown ] ; # 0..1 How is rate aggregation performed for this measure
  fhir:rationale [ markdown ] ; # 0..1 Justification for the measure in terms of impact, gap in care, and evidence
  fhir:clinicalRecommendationStatement [ markdown ] ; # 0..1 Summary of clinical guidelines
  fhir:
  fhir:

  fhir:term ( [ # 0..* Defined terms used in the measure documentation
    fhir:code [ CodeableConcept ] ; # 0..1 What term?
    fhir:definition [ markdown ] ; # 0..1 Meaning of the term
  ] ... ) ;
  fhir:guidance [ markdown ] ; # 0..1 Additional guidance for implementers (deprecated)
  fhir:group ( [ # 0..* I Population criteria group
    fhir:linkId [ string ] ; # 0..1 Unique id for group in measure
    fhir:title [ string ] ; # 0..1 Title of the group. This title is expected in the corresponding MeasureReport.group.title

    fhir:code [ CodeableConcept ] ; # 0..1 Meaning of the group
    fhir:description [ markdown ] ; # 0..1 Summary description
    fhir:type  ( [ CodeableConcept ] ... ) ; # 0..* process | outcome | structure | patient-reported-outcome
    # . One of these 2
      fhir: ]
      fhir:) ]

    # subject[x] : 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2
      fhir:subject [  a fhir:CodeableConcept ; CodeableConcept ]
      fhir:subject [  a fhir:Reference ; Reference(Group) ]

    fhir:basis [ code ] ; # 0..1 Population basis
    fhir:basisRequirement  ( [ DataRequirement ] ... ) ; # 0..* Population basis requirements

    fhir:scoring [ CodeableConcept ] ; # 0..1 proportion | ratio | continuous-variable | cohort | composite
    fhir:scoringUnit [ CodeableConcept ] ; # 0..1 What units?
    fhir:scoringPrecision [ positiveInt ] ; # 0..1 How many decimals (The number of decimal places to include in the score when the score is a decimal-valued result)
    fhir:compositeScoring [ CodeableConcept ] ; # 0..1 opportunity | all-or-nothing | linear | weighted
    fhir:component ( [ # 0..* A component of a composite measure
      fhir:measure [ canonical ] ; # 0..1 What measure?
      fhir:groupId [ string ] ; # 0..1 What group?
      fhir:weight [ decimal ] ; # 0..1 What weight?
    ] ... ) ;
    fhir:rateAggregation [ markdown ] ; # 0..1 How is rate aggregation performed for this measure
    fhir:improvementNotation [ CodeableConcept ] ; # 0..1 increase | decrease
    fhir:improvementNotationGuidance [ markdown ] ; # 0..1 Explanation of improvement notation
    fhir:library  ( [ canonical(Library) ] ... ) ; # 0..* Logic used by the measure group
    fhir:population ( [ # 0..* Population criteria
      fhir:linkId [ string ] ; # 0..1 Unique id for population in measure
      fhir:title [ string ] ; # 0..1 Title of the group's population. This title is expected in the corresponding MeasureReport.group.population.title

      fhir:code [ CodeableConcept ] ; # 0..1 initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      fhir:description [ markdown ] ; # 0..1 The human readable description of this population criteria
      fhir:criteria [ Expression ] ; # 0..1 The criteria that defines this population
      fhir:groupDefinition [ Reference(Group) ] ; # 0..1 A group resource that defines this population
      fhir:inputPopulationId [ string ] ; # 0..1 Which population
      fhir:aggregateMethod [ CodeableConcept ] ; # 0..1 Aggregation method for a measure score (e.g. sum, average, median, minimum, maximum, count)
    ] ... ) ;
    fhir:

    fhir:stratifier ( [ # 0..* I Stratifier criteria for the measure

      fhir:linkId [ string ] ; # 0..1 Unique id for stratifier in measure
      fhir:title [ string ] ; # 0..1 Title of a group's stratifier. This title is expected in the corresponding MeasureReport.group.title

      fhir:code [ CodeableConcept ] ; # 0..1 I Meaning of the stratifier
      fhir:description [ markdown ] ; # 0..1 I The human readable description of this stratifier
      fhir:

      fhir:criteria [ Expression ] ; # 0..1 I How the measure should be stratified

      fhir:groupDefinition [ Reference(Group) ] ; # 0..1 A group resource that defines this population
      fhir:
      fhir:
      fhir:

      fhir:component ( [ # 0..* I Stratifier criteria component for the measure

        fhir:linkId [ string ] ; # 0..1 Unique id for stratifier component in measure
        fhir:code [ CodeableConcept ] ; # 0..1 Meaning of the stratifier component
        fhir:description [ markdown ] ; # 0..1 The human readable description of this stratifier component
        fhir:

        fhir:criteria [ Expression ] ; # 0..1 Component of how the measure should be stratified

        fhir:groupDefinition [ Reference(Group) ] ; # 0..1 A group resource that defines this population
        fhir:valueSet [ canonical(ValueSet) ] ; # 0..1 What stratum values?
        fhir:unit [ string ] ; # 0..1 What units?
      ] ... ) ;
    ] ... ) ;
  ] ... ) ;
  fhir:supplementalData ( [ # 0..* What other data should be reported with the measure
    fhir:linkId [ string ] ; # 0..1 Unique id for supplementalData in measure
    fhir:code [ CodeableConcept ] ; # 0..1 Meaning of the supplemental data
    fhir:usage  ( [ CodeableConcept ] ... ) ; # 0..* supplemental-data | risk-adjustment-factor
    fhir:description [ markdown ] ; # 0..1 The human readable description of this supplemental data
    fhir:criteria [ Expression ] ; # 1..1 Expression describing additional data to be reported
    fhir:valueSet [ canonical(ValueSet) ] ; # 0..1 What supplemental data values?
    fhir:unit [ string ] ; # 0..1 What units?
  ] ... ) ;
]

Changes from both R4 and R4B

Measure.group.stratifier.description Type changed from string to markdown
Measure
Measure.versionAlgorithm[x]
  • Added Element
Measure.subject[x]
  • Change value set from http://hl7.org/fhir/ValueSet/subject-type to Participant Resource Types
  • Change code system for extensibly bound codes from "http://hl7.org/fhir/resource-types" to "http://hl7.org/fhir/fhir-types"
Measure.basis Measure.jurisdiction
Measure.usage
  • Type changed from string to markdown
Measure.copyrightLabel
  • Added Element
Measure.reportingFrequency
  • Added Element
Measure.scoring Change value set from http://hl7.org/fhir/ValueSet/measure-scoring to Measure Scoring Measure.scoringUnit Added Element Measure.scoringPrecision Added Element Measure.compositeScoring Change value set from http://hl7.org/fhir/ValueSet/composite-measure-scoring to CompositeMeasureScoring Measure.type Change value set from http://hl7.org/fhir/ValueSet/measure-type to MeasureType Measure.riskAdjustment
  • Type changed from string to markdown
Measure.rateAggregation
  • Type changed from string to markdown
Measure.improvementNotation Measure.term
  • Change value set from http://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.0 to MeasureImprovementNotation Added Element
Measure.improvementNotationGuidance Measure.term.code
  • Added Element
Measure.term Measure.term.definition
  • Added Element
Measure.term.code Measure.group.linkId
  • Added Element
Measure.term.definition Measure.group.title
  • Added Element
Measure.group.linkId Measure.group.description
  • Added Element Type changed from string to markdown
Measure.group.description Measure.group.type
  • Type changed from string to markdown Added Element
Measure.group.type Measure.group.subject[x]
  • Added Element
Measure.group.subject[x] Measure.group.basis
  • Added Element
Measure.group.basis Measure.group.basisRequirement
  • Added Element
Measure.group.scoring
  • Added Element
Measure.group.scoringUnit
  • Added Element
Measure.group.scoringPrecision
  • Added Element
Measure.group.compositeScoring
  • Added Element
Measure.group.component
  • Added Element
Measure.group.component.measure
  • Added Element
Measure.group.component.groupId
  • Added Element
Measure.group.component.weight
  • Added Element
Measure.group.rateAggregation
  • Added Element
Measure.group.improvementNotation
  • Added Element
Measure.group.improvementNotationGuidance
  • Added Element
Measure.group.library
  • Added Element
Measure.group.population.linkId
  • Added Element
Measure.group.population.title
  • Added Element
Measure.group.population.code
Measure.group.population.description
  • Type changed from string to markdown
Measure.group.population.criteria
  • Min Cardinality changed from 1 to 0
Measure.group.population.groupDefinition
  • Added Element
Measure.group.population.inputPopulationId
  • Added Element
Measure.group.population.aggregateMethod
  • Added Element
Measure.group.stratifier.linkId
  • Added Element
Measure.group.stratifier.groupDefinition Measure.group.stratifier.title
  • Added Element
Measure.group.stratifier.valueSet Measure.group.stratifier.description
  • Added Element Type changed from string to markdown
Measure.group.stratifier.unit Measure.group.stratifier.groupDefinition
  • Added Element
Measure.group.stratifier.component.linkId
  • Added Element
Measure.group.stratifier.component.description
  • Type changed from string to markdown
Measure.group.stratifier.component.criteria
  • Min Cardinality changed from 1 to 0
Measure.group.stratifier.component.groupDefinition
  • Added Element
Measure.group.stratifier.component.valueSet
  • Added Element
Measure.group.stratifier.component.unit
  • Added Element
Measure.supplementalData.linkId
  • Added Element
Measure.supplementalData.usage
  • Change value set from http://hl7.org/fhir/ValueSet/measure-data-usage to MeasureDataUsage icon
Measure.supplementalData.description
  • Type changed from string to markdown
Measure.supplementalData.valueSet
  • Added Element
Measure.supplementalData.unit
  • Added Element
Measure.scoring
  • Deleted
Measure.compositeScoring
  • Deleted
Measure.type
  • Deleted
Measure.improvementNotation
  • Deleted
Measure.definition
  • Deleted (->term.definition term is code and definition now)

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON .

Structure

Intended jurisdiction for Use and/or publishing XD scoring Σ XD 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort | composite (deprecated, use group.scoring) Binding: Measure Scoring ( Extensible ) scoringUnit Σ XD 0..1 CodeableConcept What units? (deprecated, use group.scoringUnit) Binding: Measure Scoring Unit ( Example ) scoringPrecision Σ XD 0..1 positiveInt How many decimals (The number of decimal places to include in the score when the score is a decimal-valued result) (deprecated, use group.scoringPrecision) compositeScoring Σ XD 0..1 CodeableConcept opportunity | all-or-nothing | linear | weighted (deprecated, use group.compositeScoring) Binding: CompositeMeasureScoring ( Extensible ) type Σ XD 0..* CodeableConcept process | outcome | structure | patient-reported-outcome | composite (deprecated, use group.type) Binding: MeasureType ( Extensible ) improvementNotation Σ XD 0..1 CodeableConcept increase | decrease Binding: MeasureImprovementNotation ( Required ) improvementNotationGuidance Σ XD 0..1 markdown Explanation of improvement notation (deprecated, use group.improvementNotationGuidance) valueSet 0..1 canonical ( ValueSet ) What stratum values? unit 0..1 string What units?
Name Flags Card. Type Description & Constraints      Filter: Filters doco
. . Measure TU DomainResource A quality measure definition
+ Warning: Name should be usable as an identifier for the module by machine processing applications such as code generation
+ Rule: Stratifier SHALL be either a single criteria or a set of criteria components

Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
Interfaces Implemented: MetadataResource
. . . url Σ C 0..1 uri Canonical identifier for this measure, represented as a URI (globally unique)
+ Warning: URL should not contain | or # - these characters make processing canonical references problematic
. . . identifier Σ 0..* Identifier Additional identifier for the measure

. . . version Σ 0..1 string Business version of the measure
. . . versionAlgorithm[x] Σ 0..1 How to compare versions
Binding: Version Algorithm ( Extensible )
. . . . versionAlgorithmString string
. . . . versionAlgorithmCoding Coding
. . . name Σ C 0..1 string Name for this measure (computer friendly)
. . . title Σ T 0..1 string Name for this measure (human friendly)
. . . subtitle T 0..1 string Subordinate title of the measure
. . . status ?! Σ 1..1 code draft | active | retired | unknown
Binding: PublicationStatus ( Required )
. . . experimental Σ 0..1 boolean For testing only - never for real usage
. . . subject[x] 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
Binding: Participant Resource Types ( Extensible )
. . . . subjectCodeableConcept CodeableConcept
. . . . subjectReference Reference ( Group )
. . . basis Σ XD 0..1 code Population basis (deprecated, use group.basis) Binding: All FHIR Types ( Required ) date Σ 0..1 dateTime Date last changed
. . . publisher Σ T 0..1 string Name of the publisher/steward (organization or individual)
. . . contact Σ 0..* ContactDetail Contact details for the publisher

. . . description Σ T 0..1 markdown Natural language description of the measure
. . . useContext Σ 0..* UsageContext The context that the content is intended to support

. . . jurisdiction Σ XD 0..* CodeableConcept Jurisdiction of the authority that maintains the measure (if applicable)
Binding: Jurisdiction ValueSet icon ( Extensible )

. . . purpose T 0..1 markdown Why this measure is defined
. . . usage T 0..1 markdown Describes the clinical usage of the measure
. . . copyright T 0..1 markdown Notice about intellectual property ownership, can include restrictions on use
. . . copyrightLabel T 0..1 string Copyright holder and year(s)
. . . approvalDate 0..1 date When the measure was approved by publisher
. . . lastReviewDate 0..1 date When the measure was last reviewed by the publisher
. . . effectivePeriod Σ 0..1 Period When the measure is expected to be used
. . . reportingFrequency 0..1 Quantity The frequency in which this measure should be reported (e.g. 1 '/a' - yearly, 4 '/a' - quarterly)
Binding: Frequency Unit ( Extensible )
. . . topic 0..* CodeableConcept The category of the measure, such as Education, Treatment, Assessment, etc
Binding: Definition Topic ( Example )

. . . author 0..* ContactDetail Who authored the content

. . . editor 0..* ContactDetail Who edited the content

. . . reviewer 0..* ContactDetail Who reviewed the content

. . . endorser 0..* ContactDetail Who endorsed the content

. . . relatedArtifact C 0..* RelatedArtifact Additional documentation, citations, etc
+ Warning: Dependencies and components of a Measure should reference a resource

. . . library 0..* canonical ( Library ) Logic used by the measure

. . . disclaimer Σ 0..1 markdown Disclaimer for use of the measure or its referenced content
. . . riskAdjustment Σ 0..1 markdown How risk adjustment is applied for this measure
. . . rateAggregation Σ 0..1 markdown How is rate aggregation performed for this measure
. . . rationale Σ 0..1 markdown Justification for the measure in terms of impact, gap in care, and evidence
. . . clinicalRecommendationStatement Σ 0..1 markdown Summary of clinical guidelines
. . . term 0..* BackboneElement Defined terms used in the measure documentation

. . . . code 0..1 CodeableConcept What term?
Binding: Measure Definition Example ( Example )
. . . . definition 0..1 markdown Meaning of the term
. . . guidance Σ XD 0..1 markdown Additional guidance for implementers (deprecated)
. . . group C 0..* BackboneElement Population criteria group

. . . . linkId C 0..1 string Unique id for group in measure
+ Warning: Link ids should be 255 characters or less
. . . . title 0..1 string Title of the group. This title is expected in the corresponding MeasureReport.group.title
.... code 0..1 CodeableConcept Meaning of the group
Binding: Measure Group Example ( Example )
. . . . description 0..1 markdown Summary description
. . . . type Σ 0..* CodeableConcept process | outcome | structure | patient-reported-outcome
Binding: MeasureType icon ( Extensible )

. . . . subject[x] 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
Binding: Participant Resource Types ( Extensible )
. . . . . subjectCodeableConcept CodeableConcept
. . . . . subjectReference Reference ( Group )
. . . . basis Σ 0..1 code Population basis
Binding: All FHIR Types ( Required )
. . . . basisRequirement C 0..* DataRequirement Population basis requirements
+ Rule: Basis requirements SHALL have a type, MAY have profile and codeFilter elements, and SHALL NOT specify dateFilter, valueFilter, limit, or sort

. . . . scoring Σ 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort | composite
Binding: Measure Scoring icon ( Extensible )
. . . . scoringUnit Σ 0..1 CodeableConcept What units?
Binding: Measure Scoring Unit ( Example )
. . . . scoringPrecision Σ 0..1 positiveInt How many decimals (The number of decimal places to include in the score when the score is a decimal-valued result)
. . . . compositeScoring Σ 0..1 CodeableConcept opportunity | all-or-nothing | linear | weighted
Binding: CompositeMeasureScoring icon ( Extensible )
. . . . component 0..* BackboneElement A component of a composite measure

. . . . . measure 0..1 canonical () What measure?
. . . . . groupId 0..1 string What group?
. . . . . weight 0..1 decimal What weight?
. . . . rateAggregation Σ 0..1 markdown How is rate aggregation performed for this measure
. . . . improvementNotation Σ 0..1 CodeableConcept increase | decrease
Binding: MeasureImprovementNotation icon ( Extensible )
. . . . improvementNotationGuidance Σ 0..1 markdown Explanation of improvement notation
. . . . library 0..* canonical ( Library ) Logic used by the measure group

. . . . population 0..* BackboneElement Population criteria

. . . . . linkId C 0..1 string Unique id for population in measure
+ Warning: Link ids should be 255 characters or less
. . . . . title 0..1 string Title of the group's population. This title is expected in the corresponding MeasureReport.group.population.title
..... code 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType icon ( Extensible )
. . . . . description 0..1 markdown The human readable description of this population criteria
. . . . . criteria 0..1 Expression The criteria that defines this population
. . . . . groupDefinition 0..1 Reference ( Group ) A group resource that defines this population
. . . . . inputPopulationId 0..1 string Which population
. . . . . aggregateMethod 0..1 CodeableConcept Aggregation method for a measure score (e.g. sum, average, median, minimum, maximum, count)
Binding: Measure Aggregate Method icon ( Extensible )
. . . . stratifier C 0..* BackboneElement Stratifier criteria for the measure

. . . . . linkId C 0..1 string Unique id for stratifier in measure
+ Warning: Link ids should be 255 characters or less
. . . . . title 0..1 string Title of a group's stratifier. This title is expected in the corresponding MeasureReport.group.title
. . . . . code C 0..1 CodeableConcept Meaning of the stratifier
Binding: Measure Stratifier Example ( Example )
. . . . . description C 0..1 markdown The human readable description of this stratifier
. . . . . criteria C 0..1 Expression How the measure should be stratified
. . . . . groupDefinition 0..1 Reference ( Group ) A group resource that defines this population
. . . . . component C 0..* BackboneElement Stratifier criteria component for the measure

. . . . . . linkId C 0..1 string Unique id for stratifier component in measure
+ Warning: Link ids should be 255 characters or less
. . . . . . code 0..1 CodeableConcept Meaning of the stratifier component
Binding: Measure Stratifier Example ( Example )
. . . . . . description 0..1 markdown The human readable description of this stratifier component
. . . . . . criteria 0..1 Expression Component of how the measure should be stratified
. . . . . . groupDefinition 0..1 Reference ( Group ) A group resource that defines this population
. . . . . . valueSet 0..1 canonical ( ValueSet ) What stratum values?
. . . . . . unit 0..1 string What units?
. . . supplementalData 0..* BackboneElement What other data should be reported with the measure

. . . . linkId C 0..1 string Unique id for supplementalData in measure
+ Warning: Link ids should be 255 characters or less
. . . . code 0..1 CodeableConcept Meaning of the supplemental data
Binding: Measure Supplemental Data Example ( Example )
. . . . usage 0..* CodeableConcept supplemental-data | risk-adjustment-factor
Binding: MeasureDataUsage icon ( Extensible )

. . . . description 0..1 markdown The human readable description of this supplemental data
. . . . criteria 1..1 Expression Expression describing additional data to be reported
. . . . valueSet 0..1 canonical ( ValueSet ) What supplemental data values?
. . . . unit 0..1 string What units?

doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

Measure ( DomainResource ) + MetadataResource An absolute URI that is used to identify this measure when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which an authoritative instance of this measure is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the measure is stored on different servers url : uri [0..1] 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 identifier : Identifier [0..*] 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 version : string [0..1] Indicates the mechanism used to compare versions to determine which is more current versionAlgorithm[x] : DataType [0..1] « string | Coding ; null (Strength=Extensible) VersionAlgorithm + » 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 name : string [0..1] « This element has or is affected by some invariants C » A short, descriptive, user-friendly title for the measure title : string [0..1] An explanatory or alternate title for the measure giving additional information about its content subtitle : string [0..1] The status of this measure. Enables tracking the life-cycle of the content (this element modifies the meaning of other elements) status : code [1..1] « null (Strength=Required) PublicationStatus ! » A Boolean value to indicate that this measure is authored for testing purposes (or education/evaluation/marketing) and no version of this resource will ever be intended for genuine usage experimental : boolean [0..1] 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 subject[x] : DataType [0..1] « CodeableConcept | Reference ( Group ); null (Strength=Extensible) ParticipantResourceTypes + » 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 a population basis of Encounter, and the population criteria all return lists of Encounters basis : code [0..1] « null (Strength=Required) FHIRTypes ! » The date (and optionally time) when the measure was last significantly changed. The date must change 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 date : dateTime [0..1] The name of the organization or individual responsible for the release and ongoing maintenance of the measure publisher : string [0..1] Contact details to assist a user in finding and communicating with the publisher contact : ContactDetail [0..*] A free text natural language description of the measure from a consumer's perspective description : markdown [0..1] 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 useContext : UsageContext [0..*] A legal or geographic region in which the measure authority that maintains the resource is intended to be used 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 jurisdiction : CodeableConcept [0..*] « null (Strength=Extensible) JurisdictionValueSet + » Explanation of why this measure is needed and why it has been designed as it has purpose : markdown [0..1] A detailed description, from a clinical perspective, of how the measure is used usage : markdown [0..1] A copyright statement relating to the measure and/or its contents. Copyright statements are generally legal notices of intellectual property ownership and can include restrictions on the use and publishing of the measure copyright : markdown [0..1] A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. restricted. (e.g. 'All rights reserved', 'Some rights reserved') copyrightLabel : string [0..1] The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage approvalDate : date [0..1] The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date lastReviewDate : date [0..1] The period during which the measure content was or is planned to be in active use effectivePeriod : Period [0..1] The frequency that this measure should be reported, usually specified by the program it is being submitted to reportingFrequency : Quantity [0..1] « null (Strength=Extensible) FrequencyUnit + » Descriptive topics related to the content of the measure. Topics provide a high-level categorization grouping types of measures that can be useful for filtering and searching topic : CodeableConcept [0..*] « null (Strength=Example) DefinitionTopic ?? » An individiual or organization primarily involved in the creation and maintenance of the content author : ContactDetail [0..*] An individual or organization primarily responsible for internal coherence of the content editor : ContactDetail [0..*] An individual or organization asserted by the publisher to be primarily responsible for review of some aspect of the content reviewer : ContactDetail [0..*] An individual or organization asserted by the publisher to be responsible for officially endorsing the content for use in some setting endorser : ContactDetail [0..*] Related artifacts such as additional documentation, justification, or bibliographic references relatedArtifact : RelatedArtifact [0..*] A reference to a Library resource containing the formal logic used by the measure library : canonical [0..*] « Library » Notices and disclaimers regarding the use of the measure or related to intellectual property (such as code systems) referenced by the measure disclaimer : markdown [0..1] Deprecated, use group.scoring. 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 scoring : CodeableConcept [0..1] « null (Strength=Extensible) MeasureScoring + » Deprecated, use group.scoringUnit. Defines the expected units of measure for the measure score. This element SHOULD be specified as a UCUM unit scoringUnit : CodeableConcept [0..1] « null (Strength=Example) MeasureScoringUnit ?? » Deprecated, use group.scoringPrecision) When the score is a decimal value this should be used to specify the expected minimum number of digits after the decimal point to use for the precision of 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 scoringPrecision : positiveInt [0..1] Deprecated, use group.compositeScoring. If this is a composite measure, the scoring method used to combine the component measures to determine the composite score compositeScoring : CodeableConcept [0..1] « null (Strength=Extensible) CompositeMeasureScoring + » Deprecated, use group.type. 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 type : CodeableConcept [0..*] « null (Strength=Extensible) MeasureType + » 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 riskAdjustment : markdown [0..1] Describes how to combine the information calculated, based on logic in each of several populations, into one summarized result rateAggregation : markdown [0..1] Provides a detailed justification of the need for the measure including statements pertaining to importance criterion: impact, gap in care, and evidence rationale : markdown [0..1] Provides a summary of relevant clinical guidelines or other clinical recommendations supporting the measure clinicalRecommendationStatement : markdown [0..1] Deprecated, use group.improvementNotation. 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 within a range) improvementNotation : CodeableConcept [0..1] « null (Strength=Required) MeasureImprovementNotation ! » Deprecated, use group.improvementNotationGuidance. Narrative text to explain the improvement notation and how to interpret it improvementNotationGuidance : markdown [0..1] Additional guidance for the measure including how it can be used in a clinical context, and the intent of the measure guidance : markdown [0..1] Term A codeable representation of the defined term code : CodeableConcept [0..1] « null (Strength=Example) MeasureDefinitionExample ?? » Provides a definition for the term as used within the measure definition : markdown [0..1] Group An identifier that is unique within the Measure allowing linkage to the equivalent item in a MeasureReport resource linkId : string [0..1] Indicates the title for the group title : string [0..1] 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 code : CodeableConcept [0..1] « null (Strength=Example) MeasureGroupExample ?? » The human readable description of this population group description : markdown [0..1] 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 type : CodeableConcept [0..*] « null (Strength=Extensible) MeasureType + » The intended subjects for the measure. If this element is not provided, the root subject there is used to determine no subject context (i.e. population criteria are evaluated from the group perspective of the entire system, rather than from the perspective of a particular subject) subject[x] : DataType [0..1] « CodeableConcept | Reference ( Group ); null (Strength=Extensible) ParticipantResourceTypes + » 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 a population basis of Encounter, and the population criteria all return lists of Encounters basis : code [0..1] « null (Strength=Required) FHIRTypes ! » 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 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) basisRequirement : DataRequirement [0..*] 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 scoring : CodeableConcept [0..1] « null (Strength=Extensible) MeasureScoring + » Defines the expected units of measure for the measure score. This element SHOULD be specified as a UCUM unit scoringUnit : CodeableConcept [0..1] « null (Strength=Example) MeasureScoringUnit ?? » When the score is a decimal value this should be used to specify the expected minimum number of digits after the decimal point to use for the precision of 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 scoringPrecision : positiveInt [0..1] If this is a composite measure, the scoring method used to combine the component measures to determine the composite score compositeScoring : CodeableConcept [0..1] « null (Strength=Extensible) CompositeMeasureScoring + » Describes how to combine the information calculated, based on logic in each of several populations, into one summarized result rateAggregation : markdown [0..1] 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 within a range). Exercise caution when using any values besides increase or decrease for improvementNotation improvementNotation : CodeableConcept [0..1] « null (Strength=Extensible) MeasureImprovementNotation + » Narrative text to explain the improvement notation and how to interpret it improvementNotationGuidance : markdown [0..1] A reference to a Library resource containing the formal logic used by the measure group library : canonical [0..*] « Library » Component The measure that contains the definition of the component calculation measure : canonical [0..1] « » Specifies the id of a particular group within the measure referenced by the related artifact resource groupId : string [0..1] What is the weight of the contribution of this measure to the overall score weight : decimal [0..1] Population An identifier that is unique within the Measure allowing linkage to the equivalent population in a MeasureReport resource linkId : string [0..1] Indicates the title for the group's population title : string [0..1] The type of population criteria code : CodeableConcept [0..1] « null (Strength=Extensible) MeasurePopulationType + » The human readable description of this population criteria description : markdown [0..1] An expression that specifies the criteria for the population, typically the name of an expression in a library criteria : Expression [0..1] A Group resource that defines this population as a set of characteristics groupDefinition : Reference [0..1] « Group » The id of a population element in this 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 inputPopulationId : string [0..1] 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 information must be specified to ensure correct calculation aggregateMethod : CodeableConcept [0..1] « null (Strength=Extensible) MeasureAggregateMethod + » Stratifier An identifier that is unique within the Measure allowing linkage to the equivalent item in a MeasureReport resource linkId : string [0..1] Indicates the title for the stratifier of the group title : string [0..1] 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 code : CodeableConcept [0..1] « null (Strength=Example) MeasureStratifierExample ?? » « This element has or is affected by some invariants C » The human readable description of this stratifier criteria description : markdown [0..1] « This element has or is affected by some invariants C » An expression that specifies the criteria a criteria-based stratifier for the stratifier. measure. This is typically the name of an expression defined within a referenced library, but it may also be a path to a stratifier element and SHALL use the same basis as other population criteria for the population group criteria : Expression [0..1] « This element has or is affected by some invariants C » A Group resource that defines this population as a set of characteristics groupDefinition : Reference [0..1] « Group » 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) valueSet : canonical [0..1] « ValueSet » Indicates what units, if any, stratifier values are expected to be expressed in. This element SHOULD be specified in UCUM units or calendar units unit : string [0..1] Component An identifier that is unique within the Measure allowing linkage to the equivalent item in a MeasureReport resource linkId : string [0..1] Indicates a 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 code : CodeableConcept [0..1] « null (Strength=Example) MeasureStratifierExample ?? » The human readable description of this stratifier criteria component description : markdown [0..1] An expression that specifies returns the criteria for value of this component of the stratifier. stratifier for a member of the population. This is typically the name of an expression defined within a referenced library, but it may also be a path to a stratifier element 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 criteria : Expression [0..1] A Group resource that defines this population as a set of characteristics groupDefinition : Reference [0..1] « Group » 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) valueSet : canonical [0..1] « ValueSet » Indicates what units, if any, stratifier values are expected to be expressed in. This element SHOULD be specified in UCUM units or calendar units unit : string [0..1] SupplementalData An identifier that is unique within the Measure allowing linkage to the equivalent item in a MeasureReport resource linkId : string [0..1] 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 code : CodeableConcept [0..1] « null (Strength=Example) MeasureSupplementalDataExample ?? » 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 usage : CodeableConcept [0..*] « null (Strength=Extensible) MeasureDataUsage + » The human readable description of this supplemental data description : markdown [0..1] The criteria for the supplemental data. This is typically the name of a valid expression defined within a referenced library, but it may also be a path to a specific data element. The criteria defines the data to be returned for this element criteria : Expression [1..1] 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) valueSet : canonical [0..1] « ValueSet » Indicates what units, if any, supplemental data values are expected to be expressed in. This element SHOULD be specified in UCUM units or calendar units unit : string [0..1] Provides a description of an individual term used within the measure term [0..*] If this is a composite measure, a component of the composite component [0..*] A population criteria for the measure population [0..*] A component of the a value-based stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library or a valid FHIR Resource Path component [0..*] The A stratifier criteria for the measure report, measure, specified as either the name of a valid CQL expression defined within a referenced library criteria expression, or a valid FHIR Resource Path set of components that define value-based stratifier expressions stratifier [0..*] A group of population criteria for the measure group [0..*] 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 supplementalData [0..*]

XML Template 

<Measure xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <url value="[uri]"/><!-- 0..1 Canonical identifier for this measure, represented as a URI (globally unique) -->
 <identifier><!-- 0..* Identifier Additional identifier for the measure --></identifier>
 <version value="[string]"/><!-- 0..1 Business version of the measure -->
 <versionAlgorithm[x]><!-- 0..1 string|Coding How to compare versions --></versionAlgorithm[x]>
 <name value="[string]"/><!-- I 0..1 Name for this measure (computer friendly) -->
 <title value="[string]"/><!-- 0..1 Name for this measure (human friendly) -->
 <subtitle value="[string]"/><!-- 0..1 Subordinate title of the measure -->
 <status value="[code]"/><!-- 1..1 draft | active | retired | unknown -->
 <experimental value="[boolean]"/><!-- 0..1 For testing only - never for real usage -->
 <subject[x]><!-- 0..1 CodeableConcept|Reference(Group) E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device --></subject[x]>
 <

 <date value="[dateTime]"/><!-- 0..1 Date last changed -->
 <publisher value="[string]"/><!-- 0..1 Name of the publisher/steward (organization or individual) -->
 <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact>
 <description value="[markdown]"/><!-- 0..1 Natural language description of the measure -->
 <useContext><!-- 0..* UsageContext The context that the content is intended to support --></useContext>
 <</jurisdiction>

 <jurisdiction><!-- 0..* CodeableConcept Jurisdiction of the authority that maintains the measure (if applicable) icon --></jurisdiction>

 <purpose value="[markdown]"/><!-- 0..1 Why this measure is defined -->
 <usage value="[markdown]"/><!-- 0..1 Describes the clinical usage of the measure -->
 <
 <

 <copyright value="[markdown]"/><!-- 0..1 Notice about intellectual property ownership, can include restrictions on use -->
 <copyrightLabel value="[string]"/><!-- 0..1 Copyright holder and year(s) -->

 <approvalDate value="[date]"/><!-- 0..1 When the measure was approved by publisher -->
 <lastReviewDate value="[date]"/><!-- 0..1 When the measure was last reviewed by the publisher -->
 <effectivePeriod><!-- 0..1 Period When the measure is expected to be used --></effectivePeriod>
 <</reportingFrequency>

 <reportingFrequency><!-- 0..1 Quantity The frequency in which this measure should be reported (e.g. 1 '/a' - yearly, 4 '/a' - quarterly) --></reportingFrequency>

 <topic><!-- 0..* CodeableConcept The category of the measure, such as Education, Treatment, Assessment, etc --></topic>
 <author><!-- 0..* ContactDetail Who authored the content --></author>
 <editor><!-- 0..* ContactDetail Who edited the content --></editor>
 <reviewer><!-- 0..* ContactDetail Who reviewed the content --></reviewer>
 <endorser><!-- 0..* ContactDetail Who endorsed the content --></endorser>
 <relatedArtifact><!-- 0..* RelatedArtifact Additional documentation, citations, etc --></relatedArtifact>
 <library><!-- 0..* canonical(Library) Logic used by the measure --></library>
 <disclaimer value="[markdown]"/><!-- 0..1 Disclaimer for use of the measure or its referenced content -->
 <</scoring>
 <</scoringUnit>
 <
 <</compositeScoring>
 <</type>

 <riskAdjustment value="[markdown]"/><!-- 0..1 How risk adjustment is applied for this measure -->
 <rateAggregation value="[markdown]"/><!-- 0..1 How is rate aggregation performed for this measure -->
 <rationale value="[markdown]"/><!-- 0..1 Justification for the measure in terms of impact, gap in care, and evidence -->
 <clinicalRecommendationStatement value="[markdown]"/><!-- 0..1 Summary of clinical guidelines -->
 <</improvementNotation>
 <

 <term>  <!-- 0..* Defined terms used in the measure documentation -->
  <code><!-- 0..1 CodeableConcept What term? --></code>
  <definition value="[markdown]"/><!-- 0..1 Meaning of the term -->
 </term>
 <guidance value="[markdown]"/><!-- 0..1 Additional guidance for implementers (deprecated) -->
 <group>  <!-- I 0..* Population criteria group -->
  <linkId value="[string]"/><!-- 0..1 Unique id for group in measure -->
  <title value="[string]"/><!-- 0..1 Title of the group. This title is expected in the corresponding MeasureReport.group.title -->

  <code><!-- 0..1 CodeableConcept Meaning of the group --></code>
  <description value="[markdown]"/><!-- 0..1 Summary description -->
  <</type>
  <</subject[x]>

  <type><!-- 0..* CodeableConcept process | outcome | structure | patient-reported-outcome icon --></type>
  <subject[x]><!-- 0..1 CodeableConcept|Reference(Group) E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device --></subject[x]>

  <basis value="[code]"/><!-- 0..1 Population basis -->
  <</scoring>

  <basisRequirement><!-- 0..* DataRequirement Population basis requirements --></basisRequirement>
  <scoring><!-- 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort | composite icon --></scoring>

  <scoringUnit><!-- 0..1 CodeableConcept What units? --></scoringUnit>
  <scoringPrecision value="[positiveInt]"/><!-- 0..1 How many decimals (The number of decimal places to include in the score when the score is a decimal-valued result) -->
  <</compositeScoring>

  <compositeScoring><!-- 0..1 CodeableConcept opportunity | all-or-nothing | linear | weighted icon --></compositeScoring>

  <component>  <!-- 0..* A component of a composite measure -->
   <measure value="[canonical]"/><!-- 0..1 What measure? -->
   <groupId value="[string]"/><!-- 0..1 What group? -->
   <weight value="[decimal]"/><!-- 0..1 What weight? -->
  </component>
  <rateAggregation value="[markdown]"/><!-- 0..1 How is rate aggregation performed for this measure -->
  <</improvementNotation>

  <improvementNotation><!-- 0..1 CodeableConcept increase | decrease icon --></improvementNotation>

  <improvementNotationGuidance value="[markdown]"/><!-- 0..1 Explanation of improvement notation -->
  <library><!-- 0..* canonical(Library) Logic used by the measure group --></library>
  <population>  <!-- 0..* Population criteria -->
   <linkId value="[string]"/><!-- 0..1 Unique id for population in measure -->
   <</code>

   <title value="[string]"/><!-- 0..1 Title of the group's population. This title is expected in the corresponding MeasureReport.group.population.title -->
   <code><!-- 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation icon --></code>

   <description value="[markdown]"/><!-- 0..1 The human readable description of this population criteria -->
   <criteria><!-- 0..1 Expression The criteria that defines this population --></criteria>
   <groupDefinition><!-- 0..1 Reference(Group) A group resource that defines this population --></groupDefinition>
   <inputPopulationId value="[string]"/><!-- 0..1 Which population -->
   <</aggregateMethod>

   <aggregateMethod><!-- 0..1 CodeableConcept Aggregation method for a measure score (e.g. sum, average, median, minimum, maximum, count) icon --></aggregateMethod>

  </population>
  <

  <stratifier>  <!-- I 0..* Stratifier criteria for the measure -->

   <linkId value="[string]"/><!-- 0..1 Unique id for stratifier in measure -->
   <title value="[string]"/><!-- 0..1 Title of a group's stratifier. This title is expected in the corresponding MeasureReport.group.title -->

   <code><!-- I 0..1 CodeableConcept Meaning of the stratifier --></code>
   <description value="[markdown]"/><!-- I 0..1 The human readable description of this stratifier -->
   <</criteria>

   <criteria><!-- I 0..1 Expression How the measure should be stratified --></criteria>

   <groupDefinition><!-- 0..1 Reference(Group) A group resource that defines this population --></groupDefinition>
   <</valueSet>
   <
   <

   <component>  <!-- I 0..* Stratifier criteria component for the measure -->

    <linkId value="[string]"/><!-- 0..1 Unique id for stratifier component in measure -->
    <code><!-- 0..1 CodeableConcept Meaning of the stratifier component --></code>
    <description value="[markdown]"/><!-- 0..1 The human readable description of this stratifier component -->
    <</criteria>

    <criteria><!-- 0..1 Expression Component of how the measure should be stratified --></criteria>

    <groupDefinition><!-- 0..1 Reference(Group) A group resource that defines this population --></groupDefinition>
    <valueSet><!-- 0..1 canonical(ValueSet) What stratum values? --></valueSet>
    <unit value="[string]"/><!-- 0..1 What units? -->
   </component>
  </stratifier>
 </group>
 <supplementalData>  <!-- 0..* What other data should be reported with the measure -->
  <linkId value="[string]"/><!-- 0..1 Unique id for supplementalData in measure -->
  <code><!-- 0..1 CodeableConcept Meaning of the supplemental data --></code>
  <</usage>

  <usage><!-- 0..* CodeableConcept supplemental-data | risk-adjustment-factor icon --></usage>

  <description value="[markdown]"/><!-- 0..1 The human readable description of this supplemental data -->
  <criteria><!-- 1..1 Expression Expression describing additional data to be reported --></criteria>
  <valueSet><!-- 0..1 canonical(ValueSet) What supplemental data values? --></valueSet>
  <unit value="[string]"/><!-- 0..1 What units? -->
 </supplementalData>
</Measure>

JSON Template 

{doco
  "resourceType" : "Measure",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "url" : "<uri>", // Canonical identifier for this measure, represented as a URI (globally unique)
  "identifier" : [{ Identifier }], // Additional identifier for the measure
  "version" : "<string>", // Business version of the measure
  // versionAlgorithm[x]: How to compare versions. One of these 2:
  "versionAlgorithmString" : "<string>",
  "versionAlgorithmCoding" : { Coding },
  "name" : "<string>", // I Name for this measure (computer friendly)
  "title" : "<string>", // Name for this measure (human friendly)
  "subtitle" : "<string>", // Subordinate title of the measure
  "status" : "<code>", // R!  draft | active | retired | unknown
  "experimental" : <boolean>, // For testing only - never for real usage
  // subject[x]: E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2:
  "subjectCodeableConcept" : { CodeableConcept },
  "subjectReference" : { Reference(Group) },
  "

  "date" : "<dateTime>", // Date last changed
  "publisher" : "<string>", // Name of the publisher/steward (organization or individual)
  "contact" : [{ ContactDetail }], // Contact details for the publisher
  "description" : "<markdown>", // Natural language description of the measure
  "useContext" : [{ UsageContext }], // The context that the content is intended to support
  "

  "jurisdiction" : [{ CodeableConcept }], // Jurisdiction of the authority that maintains the measure (if applicable) icon

  "purpose" : "<markdown>", // Why this measure is defined
  "usage" : "<markdown>", // Describes the clinical usage of the measure
  "
  "

  "copyright" : "<markdown>", // Notice about intellectual property ownership, can include restrictions on use
  "copyrightLabel" : "<string>", // Copyright holder and year(s)

  "approvalDate" : "<date>", // When the measure was approved by publisher
  "lastReviewDate" : "<date>", // When the measure was last reviewed by the publisher
  "effectivePeriod" : { Period }, // When the measure is expected to be used
  "

  "reportingFrequency" : { Quantity }, // The frequency in which this measure should be reported (e.g. 1 '/a' - yearly, 4 '/a' - quarterly)

  "topic" : [{ CodeableConcept }], // The category of the measure, such as Education, Treatment, Assessment, etc
  "author" : [{ ContactDetail }], // Who authored the content
  "editor" : [{ ContactDetail }], // Who edited the content
  "reviewer" : [{ ContactDetail }], // Who reviewed the content
  "endorser" : [{ ContactDetail }], // Who endorsed the content
  "relatedArtifact" : [{ RelatedArtifact }], // Additional documentation, citations, etc
  "library" : ["<canonical(Library)>"], // Logic used by the measure
  "disclaimer" : "<markdown>", // Disclaimer for use of the measure or its referenced content
  "
  "
  "
  "
  "

  "riskAdjustment" : "<markdown>", // How risk adjustment is applied for this measure
  "rateAggregation" : "<markdown>", // How is rate aggregation performed for this measure
  "rationale" : "<markdown>", // Justification for the measure in terms of impact, gap in care, and evidence
  "clinicalRecommendationStatement" : "<markdown>", // Summary of clinical guidelines
  "
  "

  "term" : [{ // Defined terms used in the measure documentation
    "code" : { CodeableConcept }, // What term?
    "definition" : "<markdown>" // Meaning of the term
  }],
  "guidance" : "<markdown>", // Additional guidance for implementers (deprecated)
  "group" : [{ // I Population criteria group
    "linkId" : "<string>", // Unique id for group in measure
    "title" : "<string>", // Title of the group. This title is expected in the corresponding MeasureReport.group.title

    "code" : { CodeableConcept }, // Meaning of the group
    "description" : "<markdown>", // Summary description
    "

    "type" : [{ CodeableConcept }], // process | outcome | structure | patient-reported-outcome icon

    // subject[x]: E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2:
    " },
    " },

    "subjectCodeableConcept" : { CodeableConcept },
    "subjectReference" : { Reference(Group) },

    "basis" : "<code>", // Population basis
    "

    "basisRequirement" : [{ DataRequirement }], // Population basis requirements
    "scoring" : { CodeableConcept }, // proportion | ratio | continuous-variable | cohort | composite icon

    "scoringUnit" : { CodeableConcept }, // What units?
    "scoringPrecision" : "<positiveInt>", // How many decimals (The number of decimal places to include in the score when the score is a decimal-valued result)
    "

    "compositeScoring" : { CodeableConcept }, // opportunity | all-or-nothing | linear | weighted icon

    "component" : [{ // A component of a composite measure
      "measure" : "<canonical>", // What measure?
      "groupId" : "<string>", // What group?
      "weight" : <decimal> // What weight?
    }],
    "rateAggregation" : "<markdown>", // How is rate aggregation performed for this measure
    "

    "improvementNotation" : { CodeableConcept }, // increase | decrease icon

    "improvementNotationGuidance" : "<markdown>", // Explanation of improvement notation
    "library" : ["<canonical(Library)>"], // Logic used by the measure group
    "population" : [{ // Population criteria
      "linkId" : "<string>", // Unique id for population in measure
      "

      "title" : "<string>", // Title of the group's population. This title is expected in the corresponding MeasureReport.group.population.title
      "code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation icon

      "description" : "<markdown>", // The human readable description of this population criteria
      "criteria" : { Expression }, // The criteria that defines this population
      "groupDefinition" : { Reference(Group) }, // A group resource that defines this population
      "inputPopulationId" : "<string>", // Which population
      "

      "aggregateMethod" : { CodeableConcept } // Aggregation method for a measure score (e.g. sum, average, median, minimum, maximum, count) icon

    }],
    "

    "stratifier" : [{ // I Stratifier criteria for the measure

      "linkId" : "<string>", // Unique id for stratifier in measure
      "title" : "<string>", // Title of a group's stratifier. This title is expected in the corresponding MeasureReport.group.title

      "code" : { CodeableConcept }, // I Meaning of the stratifier
      "description" : "<markdown>", // I The human readable description of this stratifier
      "

      "criteria" : { Expression }, // I How the measure should be stratified

      "groupDefinition" : { Reference(Group) }, // A group resource that defines this population
      "
      "
      "

      "component" : [{ // I Stratifier criteria component for the measure

        "linkId" : "<string>", // Unique id for stratifier component in measure
        "code" : { CodeableConcept }, // Meaning of the stratifier component
        "description" : "<markdown>", // The human readable description of this stratifier component
        "

        "criteria" : { Expression }, // Component of how the measure should be stratified

        "groupDefinition" : { Reference(Group) }, // A group resource that defines this population
        "valueSet" : "<canonical(ValueSet)>", // What stratum values?
        "unit" : "<string>" // What units?
      }]
    }]
  }],
  "supplementalData" : [{ // What other data should be reported with the measure
    "linkId" : "<string>", // Unique id for supplementalData in measure
    "code" : { CodeableConcept }, // Meaning of the supplemental data
    "

    "usage" : [{ CodeableConcept }], // supplemental-data | risk-adjustment-factor icon

    "description" : "<markdown>", // The human readable description of this supplemental data
    "criteria" : { Expression }, // R!  Expression describing additional data to be reported
    "valueSet" : "<canonical(ValueSet)>", // What supplemental data values?
    "unit" : "<string>" // What units?
  }]
}

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Measure;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from 
  # from 

  # from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language
  # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension

  fhir:url [ uri ] ; # 0..1 Canonical identifier for this measure, represented as a URI (globally unique)
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Additional identifier for the measure
  fhir:version [ string ] ; # 0..1 Business version of the measure
  # versionAlgorithm[x] : 0..1 How to compare versions. One of these 2
    fhir: ]

    fhir:versionAlgorithm [  a fhir:String ; string ]

    fhir:versionAlgorithm [  a fhir:Coding ; Coding ]
  fhir:name [ string ] ; # 0..1 I Name for this measure (computer friendly)
  fhir:title [ string ] ; # 0..1 Name for this measure (human friendly)
  fhir:subtitle [ string ] ; # 0..1 Subordinate title of the measure
  fhir:status [ code ] ; # 1..1 draft | active | retired | unknown
  fhir:experimental [ boolean ] ; # 0..1 For testing only - never for real usage
  # subject[x] : 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2
    fhir:subject [  a fhir:CodeableConcept ; CodeableConcept ]
    fhir:subject [  a fhir:Reference ; Reference(Group) ]
  fhir:

  fhir:date [ dateTime ] ; # 0..1 Date last changed
  fhir:publisher [ string ] ; # 0..1 Name of the publisher/steward (organization or individual)
  fhir:contact  ( [ ContactDetail ] ... ) ; # 0..* Contact details for the publisher
  fhir:description [ markdown ] ; # 0..1 Natural language description of the measure
  fhir:useContext  ( [ UsageContext ] ... ) ; # 0..* The context that the content is intended to support
  fhir:

  fhir:jurisdiction  ( [ CodeableConcept ] ... ) ; # 0..* Jurisdiction of the authority that maintains the measure (if applicable)

  fhir:purpose [ markdown ] ; # 0..1 Why this measure is defined
  fhir:usage [ markdown ] ; # 0..1 Describes the clinical usage of the measure
  fhir:
  fhir:

  fhir:copyright [ markdown ] ; # 0..1 Notice about intellectual property ownership, can include restrictions on use
  fhir:copyrightLabel [ string ] ; # 0..1 Copyright holder and year(s)

  fhir:approvalDate [ date ] ; # 0..1 When the measure was approved by publisher
  fhir:lastReviewDate [ date ] ; # 0..1 When the measure was last reviewed by the publisher
  fhir:effectivePeriod [ Period ] ; # 0..1 When the measure is expected to be used
  fhir:reportingFrequency [ Quantity ] ; # 0..1 The frequency in which this measure should be reported (e.g. 1 '/a' - yearly, 4 '/a' - quarterly)
  fhir:topic  ( [ CodeableConcept ] ... ) ; # 0..* The category of the measure, such as Education, Treatment, Assessment, etc
  fhir:author  ( [ ContactDetail ] ... ) ; # 0..* Who authored the content
  fhir:editor  ( [ ContactDetail ] ... ) ; # 0..* Who edited the content
  fhir:reviewer  ( [ ContactDetail ] ... ) ; # 0..* Who reviewed the content
  fhir:endorser  ( [ ContactDetail ] ... ) ; # 0..* Who endorsed the content
  fhir:relatedArtifact  ( [ RelatedArtifact ] ... ) ; # 0..* Additional documentation, citations, etc
  fhir:library  ( [ canonical(Library) ] ... ) ; # 0..* Logic used by the measure
  fhir:disclaimer [ markdown ] ; # 0..1 Disclaimer for use of the measure or its referenced content
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:

  fhir:riskAdjustment [ markdown ] ; # 0..1 How risk adjustment is applied for this measure
  fhir:rateAggregation [ markdown ] ; # 0..1 How is rate aggregation performed for this measure
  fhir:rationale [ markdown ] ; # 0..1 Justification for the measure in terms of impact, gap in care, and evidence
  fhir:clinicalRecommendationStatement [ markdown ] ; # 0..1 Summary of clinical guidelines
  fhir:
  fhir:

  fhir:term ( [ # 0..* Defined terms used in the measure documentation
    fhir:code [ CodeableConcept ] ; # 0..1 What term?
    fhir:definition [ markdown ] ; # 0..1 Meaning of the term
  ] ... ) ;
  fhir:guidance [ markdown ] ; # 0..1 Additional guidance for implementers (deprecated)
  fhir:group ( [ # 0..* I Population criteria group
    fhir:linkId [ string ] ; # 0..1 Unique id for group in measure
    fhir:title [ string ] ; # 0..1 Title of the group. This title is expected in the corresponding MeasureReport.group.title

    fhir:code [ CodeableConcept ] ; # 0..1 Meaning of the group
    fhir:description [ markdown ] ; # 0..1 Summary description
    fhir:type  ( [ CodeableConcept ] ... ) ; # 0..* process | outcome | structure | patient-reported-outcome
    # . One of these 2
      fhir: ]
      fhir:) ]

    # subject[x] : 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2
      fhir:subject [  a fhir:CodeableConcept ; CodeableConcept ]
      fhir:subject [  a fhir:Reference ; Reference(Group) ]

    fhir:basis [ code ] ; # 0..1 Population basis
    fhir:basisRequirement  ( [ DataRequirement ] ... ) ; # 0..* Population basis requirements

    fhir:scoring [ CodeableConcept ] ; # 0..1 proportion | ratio | continuous-variable | cohort | composite
    fhir:scoringUnit [ CodeableConcept ] ; # 0..1 What units?
    fhir:scoringPrecision [ positiveInt ] ; # 0..1 How many decimals (The number of decimal places to include in the score when the score is a decimal-valued result)
    fhir:compositeScoring [ CodeableConcept ] ; # 0..1 opportunity | all-or-nothing | linear | weighted
    fhir:component ( [ # 0..* A component of a composite measure
      fhir:measure [ canonical ] ; # 0..1 What measure?
      fhir:groupId [ string ] ; # 0..1 What group?
      fhir:weight [ decimal ] ; # 0..1 What weight?
    ] ... ) ;
    fhir:rateAggregation [ markdown ] ; # 0..1 How is rate aggregation performed for this measure
    fhir:improvementNotation [ CodeableConcept ] ; # 0..1 increase | decrease
    fhir:improvementNotationGuidance [ markdown ] ; # 0..1 Explanation of improvement notation
    fhir:library  ( [ canonical(Library) ] ... ) ; # 0..* Logic used by the measure group
    fhir:population ( [ # 0..* Population criteria
      fhir:linkId [ string ] ; # 0..1 Unique id for population in measure
      fhir:title [ string ] ; # 0..1 Title of the group's population. This title is expected in the corresponding MeasureReport.group.population.title

      fhir:code [ CodeableConcept ] ; # 0..1 initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      fhir:description [ markdown ] ; # 0..1 The human readable description of this population criteria
      fhir:criteria [ Expression ] ; # 0..1 The criteria that defines this population
      fhir:groupDefinition [ Reference(Group) ] ; # 0..1 A group resource that defines this population
      fhir:inputPopulationId [ string ] ; # 0..1 Which population
      fhir:aggregateMethod [ CodeableConcept ] ; # 0..1 Aggregation method for a measure score (e.g. sum, average, median, minimum, maximum, count)
    ] ... ) ;
    fhir:

    fhir:stratifier ( [ # 0..* I Stratifier criteria for the measure

      fhir:linkId [ string ] ; # 0..1 Unique id for stratifier in measure
      fhir:title [ string ] ; # 0..1 Title of a group's stratifier. This title is expected in the corresponding MeasureReport.group.title

      fhir:code [ CodeableConcept ] ; # 0..1 I Meaning of the stratifier
      fhir:description [ markdown ] ; # 0..1 I The human readable description of this stratifier
      fhir:

      fhir:criteria [ Expression ] ; # 0..1 I How the measure should be stratified

      fhir:groupDefinition [ Reference(Group) ] ; # 0..1 A group resource that defines this population
      fhir:
      fhir:
      fhir:

      fhir:component ( [ # 0..* I Stratifier criteria component for the measure

        fhir:linkId [ string ] ; # 0..1 Unique id for stratifier component in measure
        fhir:code [ CodeableConcept ] ; # 0..1 Meaning of the stratifier component
        fhir:description [ markdown ] ; # 0..1 The human readable description of this stratifier component
        fhir:

        fhir:criteria [ Expression ] ; # 0..1 Component of how the measure should be stratified

        fhir:groupDefinition [ Reference(Group) ] ; # 0..1 A group resource that defines this population
        fhir:valueSet [ canonical(ValueSet) ] ; # 0..1 What stratum values?
        fhir:unit [ string ] ; # 0..1 What units?
      ] ... ) ;
    ] ... ) ;
  ] ... ) ;
  fhir:supplementalData ( [ # 0..* What other data should be reported with the measure
    fhir:linkId [ string ] ; # 0..1 Unique id for supplementalData in measure
    fhir:code [ CodeableConcept ] ; # 0..1 Meaning of the supplemental data
    fhir:usage  ( [ CodeableConcept ] ... ) ; # 0..* supplemental-data | risk-adjustment-factor
    fhir:description [ markdown ] ; # 0..1 The human readable description of this supplemental data
    fhir:criteria [ Expression ] ; # 1..1 Expression describing additional data to be reported
    fhir:valueSet [ canonical(ValueSet) ] ; # 0..1 What supplemental data values?
    fhir:unit [ string ] ; # 0..1 What units?
  ] ... ) ;
]

Changes from both R4 and R4B

Measure.group.stratifier.description Type changed from string to markdown
Measure
Measure.versionAlgorithm[x]
  • Added Element
Measure.subject[x]
  • Change value set from http://hl7.org/fhir/ValueSet/subject-type to Participant Resource Types
  • Change code system for extensibly bound codes from "http://hl7.org/fhir/resource-types" to "http://hl7.org/fhir/fhir-types"
Measure.basis Measure.jurisdiction
Measure.usage
  • Type changed from string to markdown
Measure.copyrightLabel
  • Added Element
Measure.reportingFrequency
  • Added Element
Measure.scoring Change value set from http://hl7.org/fhir/ValueSet/measure-scoring to Measure Scoring Measure.scoringUnit Added Element Measure.scoringPrecision Added Element Measure.compositeScoring Change value set from http://hl7.org/fhir/ValueSet/composite-measure-scoring to CompositeMeasureScoring Measure.type Change value set from http://hl7.org/fhir/ValueSet/measure-type to MeasureType Measure.riskAdjustment
  • Type changed from string to markdown
Measure.rateAggregation
  • Type changed from string to markdown
Measure.improvementNotation Measure.term
  • Change value set from http://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.0 to MeasureImprovementNotation Added Element
Measure.improvementNotationGuidance Measure.term.code
  • Added Element
Measure.term Measure.term.definition
  • Added Element
Measure.term.code Measure.group.linkId
  • Added Element
Measure.term.definition Measure.group.title
  • Added Element
Measure.group.linkId Measure.group.description
  • Added Element Type changed from string to markdown
Measure.group.description Measure.group.type
  • Type changed from string to markdown Added Element
Measure.group.type Measure.group.subject[x]
  • Added Element
Measure.group.subject[x] Measure.group.basis
  • Added Element
Measure.group.basis Measure.group.basisRequirement
  • Added Element
Measure.group.scoring
  • Added Element
Measure.group.scoringUnit
  • Added Element
Measure.group.scoringPrecision
  • Added Element
Measure.group.compositeScoring
  • Added Element
Measure.group.component
  • Added Element
Measure.group.component.measure
  • Added Element
Measure.group.component.groupId
  • Added Element
Measure.group.component.weight
  • Added Element
Measure.group.rateAggregation
  • Added Element
Measure.group.improvementNotation
  • Added Element
Measure.group.improvementNotationGuidance
  • Added Element
Measure.group.library
  • Added Element
Measure.group.population.linkId
  • Added Element
Measure.group.population.title
  • Added Element
Measure.group.population.code
Measure.group.population.description
  • Type changed from string to markdown
Measure.group.population.criteria
  • Min Cardinality changed from 1 to 0
Measure.group.population.groupDefinition
  • Added Element
Measure.group.population.inputPopulationId
  • Added Element
Measure.group.population.aggregateMethod
  • Added Element
Measure.group.stratifier.linkId
  • Added Element
Measure.group.stratifier.groupDefinition Measure.group.stratifier.title
  • Added Element
Measure.group.stratifier.valueSet Measure.group.stratifier.description
  • Added Element Type changed from string to markdown
Measure.group.stratifier.unit Measure.group.stratifier.groupDefinition
  • Added Element
Measure.group.stratifier.component.linkId
  • Added Element
Measure.group.stratifier.component.description
  • Type changed from string to markdown
Measure.group.stratifier.component.criteria
  • Min Cardinality changed from 1 to 0
Measure.group.stratifier.component.groupDefinition
  • Added Element
Measure.group.stratifier.component.valueSet
  • Added Element
Measure.group.stratifier.component.unit
  • Added Element
Measure.supplementalData.linkId
  • Added Element
Measure.supplementalData.usage
  • Change value set from http://hl7.org/fhir/ValueSet/measure-data-usage to MeasureDataUsage icon
Measure.supplementalData.description
  • Type changed from string to markdown
Measure.supplementalData.valueSet
  • Added Element
Measure.supplementalData.unit
  • Added Element
Measure.scoring
  • Deleted
Measure.compositeScoring
  • Deleted
Measure.type
  • Deleted
Measure.improvementNotation
  • Deleted
Measure.definition
  • Deleted (->term.definition term is code and definition now)

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON .

 

Additional definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) , the spreadsheet version & the dependency analysis

14.17.4.1 14.16.4.1 Terminology Bindings

Measure.basis FHIRTypes (a valid code from All FHIR Types ) Required All FHIR types Measure.topic DefinitionTopic Example High-level categorization of the definition, used for searching, sorting, and filtering. Measure.scoring Measure.scoringUnit
Path ValueSet Type Documentation
Measure.versionAlgorithm[x] VersionAlgorithm Extensible

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

Measure.status PublicationStatus Required

The lifecycle status of an artifact.

Measure.subject[x] ParticipantResourceTypes Extensible

All Resource Types that represent participant resources

Measure.jurisdiction JurisdictionValueSet icon Extensible

This value set defines a base set of codes for country, country subdivision and region for indicating where a resource is intended to be used.

Note: The codes for countries and country subdivisions are taken from ISO 3166 icon while the codes for "supra-national" regions are from UN Standard country or area codes for statistical use (M49) icon .

Measure.reportingFrequency MeasureScoring FrequencyUnit Extensible

The scoring type of the measure. Frequency units (i.e. per time-duration-unit).

Measure.topic MeasureScoringUnit DefinitionTopic Example

This is an example value set illustrating some typical scoring units used in quality measure specifications. Measure.compositeScoring CompositeMeasureScoring Extensible The composite scoring method of the measure. Measure.type MeasureType Extensible The type of measure (includes codes from 2.16.840.1.113883.1.11.20368). Measure.improvementNotation MeasureImprovementNotation Required Observation values that indicate what change in a measurement value or score is indicative High-level categorization of an improvement in the measured item or scored issue. definition, used for searching, sorting, and filtering.

Measure.term.code MeasureDefinitionExample Example

Example Measure Definitions for the Measure Resource.

Measure.group.code MeasureGroupExample Example

Example Measure Groups for the Measure Resource.

Measure.group.type MeasureType icon Extensible

The type of measure (includes codes from 2.16.840.1.113883.1.11.20368).

Measure.group.subject[x] ParticipantResourceTypes Extensible

All Resource Types that represent participant resources

Measure.group.basis FHIRTypes (a valid code from All FHIR Types ) Required

All FHIR types

Measure.group.scoring MeasureScoring icon Extensible

The scoring type of the measure.

Measure.group.scoringUnit MeasureScoringUnit Example

This is an example value set illustrating some typical scoring units used in quality measure specifications.

Measure.group.compositeScoring CompositeMeasureScoring icon Extensible

The composite scoring method of the measure.

Measure.group.improvementNotation MeasureImprovementNotation icon Extensible

Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.

Measure.group.population.code MeasurePopulationType icon Extensible

The type of population.

Measure.group.population.aggregateMethod MeasureAggregateMethod icon Extensible

Aggregation method for a measure (e.g. sum, average, median, minimum, maximum, count)

Measure.group.stratifier.code MeasureStratifierExample Example

Identifier subgroups in a population for measuring purposes.

Measure.group.stratifier.component.code MeasureStratifierExample Example

Identifier subgroups in a population for measuring purposes.

Measure.supplementalData.code MeasureSupplementalDataExample Example

Supplemental data in a population for measuring purposes.

Measure.supplementalData.usage MeasureDataUsage icon Extensible

The intended usage for supplemental data elements in the measure.

14.17.4.2 14.16.4.2 Constraints

UniqueKey Level Location Description Expression
img  cnl-0 Warning (base) Name should be usable as an identifier for the module by machine processing applications such as code generation name.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$')
img  mea-1 Rule (base) Stratifier SHALL be either a single criteria or a set of criteria components group.stratifier.all((code | description | criteria).exists() xor component.exists())
img  cnl-1 Warning Measure.url URL should not contain | or # - these characters make processing canonical references problematic exists() implies matches('^[^|# ]+$')
img  mea-2 Warning Measure.group.linkId Link ids should be 255 characters or less $this.length() <= 255
img  mea-3 Warning Measure.group.population.linkId Link ids should be 255 characters or less $this.length() <= 255
img  mea-4 Warning Measure.group.stratifier.linkId Link ids should be 255 characters or less $this.length() <= 255
img  mea-5 Warning Measure.group.stratifier.component.linkId Link ids should be 255 characters or less $this.length() <= 255
img  mea-6 Warning Measure.supplementalData.linkId Link ids should be 255 characters or less $this.length() <= 255
img  mea-7 Rule Measure.group.basisRequirement Basis requirements SHALL have a type, MAY have profile and codeFilter elements, and SHALL NOT specify dateFilter, valueFilter, limit, or sort dateFilter.exists().not() and valueFilter.exists().not() and limit.exists().not() and sort.exists().not()
img  mea-8 Warning Measure.relatedArtifact Dependencies and components of a Measure should reference a resource type in ('depends-on' | 'composed-of' | 'part-of') implies ((resource.exists() xor resourceReference.exists()) or (artifact is canonical xor artifact is Reference))

14.17.5 14.16.5 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource , and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
composed-of reference What resource is being referenced Measure.relatedArtifact.where(type='composed-of').resource
(Any) 		5 Resources
context token A use context assigned to the measure (Measure.useContext.value.ofType(CodeableConcept)) 30 25 Resources
context-quantity quantity A quantity- or range-valued use context assigned to the measure (Measure.useContext.value.ofType(Quantity)) | (Measure.useContext.value.ofType(Range)) 30 25 Resources
context-type token A type of use context assigned to the measure Measure.useContext.code 30 25 Resources
context-type-quantity composite A use context type and quantity- or range-based value assigned to the measure On Measure.useContext:
  context-type: code
  context-quantity: value.ofType(Quantity) | value.ofType(Range) 		30 25 Resources
context-type-value composite A use context type and value assigned to the measure On Measure.useContext:
  context-type: code
  context: value.ofType(CodeableConcept) 		30 25 Resources
date date The measure publication date Measure.date 31 26 Resources
depends-on reference What resource is being referenced Measure.relatedArtifact.where(type='depends-on').resource | Measure.library
( Library , Any) 		5 Resources
derived-from reference What resource is being referenced Measure.relatedArtifact.where(type='derived-from').resource
(Any) 		9 Resources
description string The description of the measure Measure.description 29 24 Resources
effective date The time during which the measure is intended to be in use Measure.effectivePeriod 12 10 Resources
experimental token Whether the Measure is experimental Measure.experimental
identifier token External identifier for the measure Measure.identifier 35 30 Resources
jurisdiction token Intended jurisdiction for Jurisdiction of the authority that maintains the the measure Measure.jurisdiction 27 22 Resources
name string Computationally friendly name of the measure Measure.name 28 24 Resources
predecessor reference What resource is being referenced Measure.relatedArtifact.where(type='predecessor').resource
(Any) 		9 Resources
publisher string Name of the publisher of the measure Measure.publisher 31 26 Resources
status token The current status of the measure Measure.status 35 30 Resources
subject-canonical reference The subject of the Measure when expressed as a canonical Measure.subject as canonical
( Group )
subject-code token The subject of the Measure when expressed as a code Measure.subject as CodeableConcept
subject-reference reference The subject of the Measure when expressed as a reference Measure.subject as Reference
( Group )
successor reference What resource is being referenced Measure.relatedArtifact.where(type='successor').resource
(Any) 		5 Resources
title string The human-friendly name of the measure Measure.title 28 24 Resources
topic token Topics associated with the measure Measure.topic 10 Resources
url uri The uri that identifies the measure Measure.url 35 30 Resources
version token The business version of the measure Measure.version 32 27 Resources