FHIR Release 3 (STU) R4 Ballot #1 (Mixed Normative/Trial use)

This page is part of the FHIR Specification (v3.0.2: STU 3). (v3.3.0: R4 Ballot 2). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

14.5 14.11 Resource Measure - Content

Clinical Quality Information Work Group Maturity Level : 2   Trial Use Compartments : Not linked to any defined compartments

The Measure resource provides the definition of a quality measure.

14.5.1 14.11.1 Scope and Usage

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

The Measure resource represents a structured computable definition of a clinical quality 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 contain any logic; rather a Library resource is referenced that contains the logic required by the measure, and the various expression elements, such as poulation 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.

14.5.2 14.11.2 Boundaries and Relationships

The Measure resource describes a specific quality measure, 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 CQL expressions for the actual criteria.

A Measure is also similar to an Observation resource, with the exception that the Measure is purely definitional, it contains no actual measurements, only a description of how to calculate a particular measurement.

A Measure is also similar to a clinical document, but as with the relationship to Observation, a Document is specific to a particular subject.

This resource is referenced by measurereport

14.5.3 14.11.3 Resource Content

Structure

Name Flags Card. Type Description & Constraints doco
. . Measure TU DomainResource A quality measure definition
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . url Σ 0..1 uri Logical URI to reference Canonical identifier for this measure measure, represented as a URI (globally unique)
. . . identifier Σ 0..* Identifier Additional identifier for the measure
. . . version Σ 0..1 string Business version of the measure
. . . name Σ 0..1 string Name for this measure (computer friendly)
. . . title Σ 0..1 string Name for this measure (human friendly)
. . . subtitle 0..1 string Subordinate title of the measure
... status ?! Σ 1..1 code draft | active | retired | unknown
PublicationStatus ( Required )
. . . experimental ?! Σ 0..1 boolean For testing purposes, not real usage
. . . subject[x] 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
SubjectType ( Extensible )
.... subjectCodeableConcept CodeableConcept
.... subjectReference Reference ( Group )
. . . date Σ 0..1 dateTime Date this was last changed
. . . publisher Σ 0..1 string Name of the publisher (organization or individual)
. . description . contact Σ 0..1 0..* markdown ContactDetail Natural language description of Contact details for the measure publisher
. . . purpose description Σ 0..1 markdown Why this Natural language description of the measure is defined
. . usage . useContext Σ 0..1 0..* string UsageContext Describes the clinical usage of The context that the measure content is intended to support
. . approvalDate . jurisdiction Σ 0..1 0..* date CodeableConcept When the Intended jurisdiction for measure was approved by publisher (if applicable)
Jurisdiction ValueSet ( Extensible )
. . . lastReviewDate purpose 0..1 date markdown When the Why this measure was last reviewed is defined
. . effectivePeriod . usage Σ 0..1 Period string When Describes the clinical usage of the measure is expected to be used
. . useContext . copyright Σ 0..* 0..1 UsageContext markdown Context the content is intended to support Use and/or publishing restrictions
. . jurisdiction . approvalDate Σ 0..* 0..1 CodeableConcept date Intended jurisdiction for When the measure (if applicable) Jurisdiction ValueSet ( Extensible ) was approved by publisher
. . topic . lastReviewDate 0..* 0..1 CodeableConcept date E.g. Education, Treatment, Assessment, etc DefinitionTopic ( Example ) When the measure was last reviewed
. . . contributor effectivePeriod Σ 0..* 0..1 Contributor Period A content contributor When the measure is expected to be used
. . . contact topic Σ 0..* ContactDetail CodeableConcept Contact details for The category of the publisher measure, such as Education, Treatment, Assessment, etc.
DefinitionTopic ( Example )
. . copyright . contributor 0..1 0..* markdown Contributor Use and/or publishing restrictions A content contributor
. . . relatedArtifact 0..* RelatedArtifact Additional documentation, citations, etc etc.
. . . library 0..* Reference ( Library canonical ) Logic used by the measure
. . . disclaimer Σ 0..1 markdown Disclaimer for use of the measure or its referenced content
. . . scoring Σ 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
MeasureScoring ( Extensible )
. . . compositeScoring Σ 0..1 CodeableConcept opportunity | all-or-nothing | linear | weighted
CompositeMeasureScoring ( Extensible )
. . . type Σ 0..* CodeableConcept process | outcome | structure | patient-reported-outcome | composite
MeasureType ( Extensible )
. . . riskAdjustment Σ 0..1 string How is risk adjustment is applied for this measure
. . . rateAggregation Σ 0..1 string How is rate aggregation performed for this measure
. . . rationale Σ 0..1 markdown Why does this measure exist
. . . clinicalRecommendationStatement Σ 0..1 markdown Summary of clinical guidelines
. . . improvementNotation Σ 0..1 string Improvement notation for the measure, e.g. higher score indicates better quality
. . . definition Σ 0..* markdown Defined terms used in the measure documentation
. . . guidance Σ 0..1 markdown Additional guidance for implementers
. . . set Σ 0..1 string The measure set, e.g. Preventive Care and Screening
. . . group 0..* BackboneElement Population criteria group
. . . . identifier code 1..1 Identifier Unique identifier name 0..1 string CodeableConcept Short name Meaning of the group
. . . . description 0..1 string Summary description
. . . . population 0..* BackboneElement Population criteria
. . . . . identifier 0..1 Identifier Unique identifier code 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
MeasurePopulationType ( Extensible )
. . . . . name 0..1 string Short name description 0..1 string The human readable description of this population criteria
. . . . . criteria 1..1 string The name of a valid referenced CQL expression (may be namespaced) that defines this population criteria
. . . . stratifier 0..* BackboneElement Stratifier criteria for the measure
. . . . . identifier code 0..1 Identifier CodeableConcept The identifier for Meaning of the stratifier used to coordinate the reported data back to
. . . . . description 0..1 string The human readable description of this stratifier
. . . . . criteria 0..1 string How the measure should be stratified
. . . . . path 0..1 string Path to the stratifier
. . . supplementalData 0..* BackboneElement What other data should be reported with the measure
. . . . identifier code 0..1 Identifier CodeableConcept Identifier, unique within Meaning of the measure supplemental data
. . . . usage 0..* CodeableConcept supplemental-data | risk-adjustment-factor
MeasureDataUsage ( Extensible )
. . . . description 0..1 string The human readable description of this supplemental data
.... criteria 0..1 string Expression describing additional data to be reported
. . . . path 0..1 string Path to the supplemental data element

doco Documentation for this format

UML Diagram ( Legend )

Measure ( DomainResource ) An absolute URI that is used to identify this measure when it is referenced in a specification, model, design or an instance. instance; also called its canonical identifier. This SHALL be a URL, SHOULD be globally unique, unique and SHOULD be an a literal address at which this measure is (or will be) published. The URL SHOULD include the major version of the measure. For more information see [Technical and Business Versions](resource.html#versions) published 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] 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] 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] « The lifecycle status of a Value Set or Concept Map. an artifact. (Strength=Required) PublicationStatus ! » A boolean Boolean value to indicate that this measure is authored for testing purposes (or education/evaluation/marketing), education/evaluation/marketing) and is not intended to be used for genuine usage (this element modifies the meaning of other elements) 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] : Type [0..1] « CodeableConcept | Reference ( Group ); The possible types of subjects for a measure (E.g. Patient, Practitioner, Organization, Location, etc.) (Strength=Extensible) SubjectType + » The date (and optionally time) when the measure was published. The date must change if and when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the measure changes date : dateTime [0..1] The name of the individual or organization or individual that published 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 terms 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 is intended to be used jurisdiction : CodeableConcept [0..*] « Countries and regions within which this artifact is targeted for use (Strength=Extensible) Jurisdiction ValueSet + » Explaination Explanation of why this measure is needed and why it has been designed as it has purpose : markdown [0..1] A detailed description description, from a clinical perspective, of how the measure is used from a clinical perspective usage : string [0..1] A copyright statement relating to the measure and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the measure copyright : markdown [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, approval but doesn't 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 content was developed with a focus and intent of supporting the contexts that are listed. These terms 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 is intended to be used jurisdiction : CodeableConcept [0..*] Countries and regions within which this artifact is targeted for use (Strength=Extensible) Jurisdiction ValueSet + Descriptive topics related to the content of the measure. Topics provide a high-level categorization grouping types of the type of the measure measures that can be useful for filtering and searching topic : CodeableConcept [0..*] « High-level categorization of the definition, used for searching, sorting, and filtering (Strength=Example) DefinitionTopic ?? » A contributor to the content of the measure, including authors, editors, reviewers, and endorsers contributor : Contributor [0..*] Contact details to assist a user in finding and communicating with the publisher contact : ContactDetail [0..*] A copyright statement relating to the measure and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the measure copyright : markdown [0..1] 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 : Reference canonical [0..*] Library Notices and disclaimers regarding the use of the measure, measure or related to intellectual property (such as code systems) referenced by the measure disclaimer : markdown [0..1] Indicates how the calculation is performed for the measure, including proportion, ratio, continuous variable, continuous-variable, and cohort. The value set is extensible, allowing additional measure scoring types to be represented scoring : CodeableConcept [0..1] « The scoring type of the measure (Strength=Extensible) MeasureScoring + » If this is a composite measure, the scoring method used to combine the component measures to determine the composite score compositeScoring : CodeableConcept [0..1] « The composite scoring method of the measure (Strength=Extensible) CompositeMeasureScoring + » 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..*] « The type of measure (includes codes from 2.16.840.1.113883.1.11.20368) (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 : string [0..1] Describes how to combine the information calculated, based on logic in each of several populations, into one summarized result rateAggregation : string [0..1] Provides a succint succinct statement of the need for the measure. Usually includes 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] Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is whthin within a range) improvementNotation : string [0..1] Provides a description of an individual term used within the measure definition : markdown [0..*] 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] The measure set, e.g. Preventive Care and Screening set : string [0..1] Group A unique identifier Indicates a meaning for the group. This identifier will used to report data for the group in the measure report identifier : Identifier [1..1] Optional name can be as simple as a unique identifier, or short description of this group it can establish meaning in a broader context by drawing from a terminology, allowing groups to be correlated across measures name code : string CodeableConcept [0..1] The human readable description of this population group description : string [0..1] Population A unique identifier for the population criteria. This identifier is used to report data against this criteria within the measure report identifier : Identifier [0..1] The type of population criteria code : CodeableConcept [0..1] « The type of population (Strength=Extensible) MeasurePopulationType + » Optional name or short description of this population name : string [0..1] The human readable description of this population criteria description : string [0..1] The name of a valid referenced CQL expression (may be namespaced) that defines this population criteria criteria : string [1..1] Stratifier The identifier Indicates a meaning for the stratifier used to coordinate the reported data back 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] The human readable description of this stratifier criteria identifier description : Identifier string [0..1] The criteria for the stratifier. This must be the name of an expression defined within a referenced library criteria : string [0..1] The path to an element that defines the stratifier, specified as a valid FHIR resource path path : string [0..1] SupplementalData An identifier 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 identifier code : Identifier CodeableConcept [0..1] 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..*] « The intended usage for supplemental data elements in the measure (Strength=Extensible) MeasureDataUsage + » The human readable description of this supplemental data description : string [0..1] The criteria for the supplemental data. This must be the name of a valid expression defined within a referenced library, and library. The criteria defines the data to be returned for this element criteria : string [0..1] The supplemental data to be supplied as part of the measure response, specified as a valid FHIR Resource Path path : string [0..1] A population criteria for the measure population [0..*] The stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library, library or a valid FHIR Resource Path 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 -->
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 <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>
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 <</effectivePeriod>
 <</useContext>

 <version value="[string]"/><!-- 0..1 Business version of the measure -->
 <name value="[string]"/><!-- 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 purposes, not 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 (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><!-- 0..* CodeableConcept Intended jurisdiction for measure (if applicable) --></jurisdiction>
 <</topic>

 <purpose value="[markdown]"/><!-- 0..1 Why this measure is defined -->
 <usage value="[string]"/><!-- 0..1 Describes the clinical usage of the measure -->
 <copyright value="[markdown]"/><!-- 0..1 Use and/or publishing restrictions -->
 <approvalDate value="[date]"/><!-- 0..1 When the measure was approved by publisher -->
 <lastReviewDate value="[date]"/><!-- 0..1 When the measure was last reviewed -->
 <effectivePeriod><!-- 0..1 Period When the measure is expected to be used --></effectivePeriod>
 <topic><!-- 0..* CodeableConcept The category of the measure, such as Education, Treatment, Assessment, etc. --></topic>

 <contributor><!-- 0..* Contributor A content contributor --></contributor>
 <</contact>
 <
 <</relatedArtifact>
 <</library>
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 <</scoring>

 <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><!-- 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort --></scoring>

 <compositeScoring><!-- 0..1 CodeableConcept opportunity | all-or-nothing | linear | weighted --></compositeScoring>
 <type><!-- 0..* CodeableConcept process | outcome | structure | patient-reported-outcome | composite --></type>
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 <riskAdjustment value="[string]"/><!-- 0..1 How risk adjustment is applied for this measure -->
 <rateAggregation value="[string]"/><!-- 0..1 How is rate aggregation performed for this measure -->
 <rationale value="[markdown]"/><!-- 0..1 Why does this measure exist -->
 <clinicalRecommendationStatement value="[markdown]"/><!-- 0..1 Summary of clinical guidelines -->
 <improvementNotation value="[string]"/><!-- 0..1 Improvement notation for the measure, e.g. higher score indicates better quality -->
 <definition value="[markdown]"/><!-- 0..* Defined terms used in the measure documentation -->
 <guidance value="[markdown]"/><!-- 0..1 Additional guidance for implementers -->
 <set value="[string]"/><!-- 0..1 The measure set, e.g. Preventive Care and Screening -->

 <group>  <!-- 0..* Population criteria group -->
  <</identifier>
  <
  <

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

  <population>  <!-- 0..* Population criteria -->
   <</identifier>

   <code><!-- 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation --></code>
   <
   <
   <

   <description value="[string]"/><!-- 0..1 The human readable description of this population criteria -->
   <criteria value="[string]"/><!-- 1..1 The name of a valid referenced CQL expression (may be namespaced) that defines this population criteria -->

  </population>
  <
   <</identifier>
   <
   <

  <stratifier>  <!-- 0..* Stratifier criteria for the measure -->
   <code><!-- 0..1 CodeableConcept Meaning of the stratifier --></code>
   <description value="[string]"/><!-- 0..1 The human readable description of this stratifier -->
   <criteria value="[string]"/><!-- 0..1 How the measure should be stratified -->
   <path value="[string]"/><!-- 0..1 Path to the stratifier -->

  </stratifier>
 </group>
 <supplementalData>  <!-- 0..* What other data should be reported with the measure -->
  <</identifier>

  <code><!-- 0..1 CodeableConcept Meaning of the supplemental data --></code>

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

  <description value="[string]"/><!-- 0..1 The human readable description of this supplemental data -->
  <criteria value="[string]"/><!-- 0..1 Expression describing additional data to be reported -->
  <path value="[string]"/><!-- 0..1 Path to the supplemental data element -->

 </supplementalData>
</Measure>

JSON Template 

{doco
  "resourceType" : "",

  "resourceType" : "Measure",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
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  "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
  "name" : "<string>", // 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 purposes, not 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 (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 }], // Intended jurisdiction for measure (if applicable)
  "purpose" : "<markdown>", // Why this measure is defined
  "usage" : "<string>", // Describes the clinical usage of the measure
  "copyright" : "<markdown>", // Use and/or publishing restrictions
  "approvalDate" : "<date>", // When the measure was approved by publisher
  "lastReviewDate" : "<date>", // When the measure was last reviewed
  "effectivePeriod" : { Period }, // When the measure is expected to be used
  "topic" : [{ CodeableConcept }], // The category of the measure, such as Education, Treatment, Assessment, etc.
  "contributor" : [{ Contributor }], // A content contributor
  "relatedArtifact" : [{ RelatedArtifact }], // Additional documentation, citations, etc.
  "library" : ["<canonical>"], // Logic used by the measure
  "disclaimer" : "<markdown>", // Disclaimer for use of the measure or its referenced content
  "scoring" : { CodeableConcept }, // proportion | ratio | continuous-variable | cohort
  "compositeScoring" : { CodeableConcept }, // opportunity | all-or-nothing | linear | weighted
  "type" : [{ CodeableConcept }], // process | outcome | structure | patient-reported-outcome | composite
  "riskAdjustment" : "<string>", // How risk adjustment is applied for this measure
  "rateAggregation" : "<string>", // How is rate aggregation performed for this measure
  "rationale" : "<markdown>", // Why does this measure exist
  "clinicalRecommendationStatement" : "<markdown>", // Summary of clinical guidelines
  "improvementNotation" : "<string>", // Improvement notation for the measure, e.g. higher score indicates better quality
  "definition" : ["<markdown>"], // Defined terms used in the measure documentation
  "guidance" : "<markdown>", // Additional guidance for implementers
  "set" : "<string>", // The measure set, e.g. Preventive Care and Screening
  "group" : [{ // Population criteria group
    "code" : { CodeableConcept }, // Meaning of the group
    "description" : "<string>", // Summary description
    "population" : [{ // Population criteria
      "code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      "description" : "<string>", // The human readable description of this population criteria
      "criteria" : "<string>" // R!  The name of a valid referenced CQL expression (may be namespaced) that defines this population criteria

    }],
    "
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      "
      "

    "stratifier" : [{ // Stratifier criteria for the measure
      "code" : { CodeableConcept }, // Meaning of the stratifier
      "description" : "<string>", // The human readable description of this stratifier
      "criteria" : "<string>", // How the measure should be stratified
      "path" : "<string>" // Path to the stratifier

    }]
  }],
  "
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  "supplementalData" : [{ // What other data should be reported with the measure
    "code" : { CodeableConcept }, // Meaning of the supplemental data
    "usage" : [{ CodeableConcept }], // supplemental-data | risk-adjustment-factor
    "description" : "<string>", // The human readable description of this supplemental data
    "criteria" : "<string>", // Expression describing additional data to be reported
    "path" : "<string>" // Path to the supplemental data element

  }]
}

Turtle Template 

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


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

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

  fhir:Measure.url [ uri ]; # 0..1 Canonical identifier for this measure, represented as a URI (globally unique)

  fhir:Measure.identifier [ Identifier ], ... ; # 0..* Additional identifier for the measure
  fhir:Measure.version [ string ]; # 0..1 Business version of the measure
  fhir:Measure.name [ string ]; # 0..1 Name for this measure (computer friendly)
  fhir:Measure.title [ string ]; # 0..1 Name for this measure (human friendly)
  fhir:Measure.subtitle [ string ]; # 0..1 Subordinate title of the measure

  fhir:Measure.status [ code ]; # 1..1 draft | active | retired | unknown
  fhir:
  fhir:
  fhir:

  fhir:Measure.experimental [ boolean ]; # 0..1 For testing purposes, not real usage
  # Measure.subject[x] : 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2
    fhir:Measure.subjectCodeableConcept [ CodeableConcept ]
    fhir:Measure.subjectReference [ Reference(Group) ]
  fhir:Measure.date [ dateTime ]; # 0..1 Date last changed
  fhir:Measure.publisher [ string ]; # 0..1 Name of the publisher (organization or individual)
  fhir:Measure.contact [ ContactDetail ], ... ; # 0..* Contact details for the publisher

  fhir:Measure.description [ markdown ]; # 0..1 Natural language description of the measure
  fhir:
  fhir:

  fhir:Measure.useContext [ UsageContext ], ... ; # 0..* The context that the content is intended to support
  fhir:Measure.jurisdiction [ CodeableConcept ], ... ; # 0..* Intended jurisdiction for measure (if applicable)
  fhir:Measure.purpose [ markdown ]; # 0..1 Why this measure is defined
  fhir:Measure.usage [ string ]; # 0..1 Describes the clinical usage of the measure
  fhir:Measure.copyright [ markdown ]; # 0..1 Use and/or publishing restrictions

  fhir:Measure.approvalDate [ date ]; # 0..1 When the measure was approved by publisher
  fhir:

  fhir:Measure.lastReviewDate [ date ]; # 0..1 When the measure was last reviewed

  fhir:Measure.effectivePeriod [ Period ]; # 0..1 When the measure is expected to be used
  fhir:
  fhir:
  fhir:

  fhir:Measure.topic [ CodeableConcept ], ... ; # 0..* The category of the measure, such as Education, Treatment, Assessment, etc.

  fhir:Measure.contributor [ Contributor ], ... ; # 0..* A content contributor
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:

  fhir:Measure.relatedArtifact [ RelatedArtifact ], ... ; # 0..* Additional documentation, citations, etc.
  fhir:Measure.library [ canonical(Library) ], ... ; # 0..* Logic used by the measure
  fhir:Measure.disclaimer [ markdown ]; # 0..1 Disclaimer for use of the measure or its referenced content
  fhir:Measure.scoring [ CodeableConcept ]; # 0..1 proportion | ratio | continuous-variable | cohort

  fhir:Measure.compositeScoring [ CodeableConcept ]; # 0..1 opportunity | all-or-nothing | linear | weighted
  fhir:Measure.type [ CodeableConcept ], ... ; # 0..* process | outcome | structure | patient-reported-outcome | composite
  fhir:

  fhir:Measure.riskAdjustment [ string ]; # 0..1 How risk adjustment is applied for this measure

  fhir:Measure.rateAggregation [ string ]; # 0..1 How is rate aggregation performed for this measure
  fhir:

  fhir:Measure.rationale [ markdown ]; # 0..1 Why does this measure exist

  fhir:Measure.clinicalRecommendationStatement [ markdown ]; # 0..1 Summary of clinical guidelines
  fhir:

  fhir:Measure.improvementNotation [ string ]; # 0..1 Improvement notation for the measure, e.g. higher score indicates better quality

  fhir:Measure.definition [ markdown ], ... ; # 0..* Defined terms used in the measure documentation
  fhir:Measure.guidance [ markdown ]; # 0..1 Additional guidance for implementers
  fhir:Measure.set [ string ]; # 0..1 The measure set, e.g. Preventive Care and Screening
  fhir:Measure.group [ # 0..* Population criteria group
    fhir:
    fhir:

    fhir:Measure.group.code [ CodeableConcept ]; # 0..1 Meaning of the group

    fhir:Measure.group.description [ string ]; # 0..1 Summary description
    fhir:Measure.group.population [ # 0..* Population criteria
      fhir:

      fhir:Measure.group.population.code [ CodeableConcept ]; # 0..1 initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      fhir:

      fhir:Measure.group.population.description [ string ]; # 0..1 The human readable description of this population criteria
      fhir:Measure.group.population.criteria [ string ]; # 1..1 The name of a valid referenced CQL expression (may be namespaced) that defines this population criteria
    ], ...;
    fhir:
      fhir:

    fhir:Measure.group.stratifier [ # 0..* Stratifier criteria for the measure
      fhir:Measure.group.stratifier.code [ CodeableConcept ]; # 0..1 Meaning of the stratifier
      fhir:Measure.group.stratifier.description [ string ]; # 0..1 The human readable description of this stratifier

      fhir:Measure.group.stratifier.criteria [ string ]; # 0..1 How the measure should be stratified
      fhir:Measure.group.stratifier.path [ string ]; # 0..1 Path to the stratifier
    ], ...;
  ], ...;
  fhir:Measure.supplementalData [ # 0..* What other data should be reported with the measure
    fhir:

    fhir:Measure.supplementalData.code [ CodeableConcept ]; # 0..1 Meaning of the supplemental data

    fhir:Measure.supplementalData.usage [ CodeableConcept ], ... ; # 0..* supplemental-data | risk-adjustment-factor
    fhir:

    fhir:Measure.supplementalData.description [ string ]; # 0..1 The human readable description of this supplemental data
    fhir:Measure.supplementalData.criteria [ string ]; # 0..1 Expression describing additional data to be reported

    fhir:Measure.supplementalData.path [ string ]; # 0..1 Path to the supplemental data element
  ], ...;
]

Changes since DSTU2 R3

Measure
Measure.subtitle
  • Added Element
Measure.subject[x]
  • Added Element
Measure.library
  • Type changed from Reference(Library) to canonical
Measure.group.code
  • Added Element
Measure.group.stratifier.code
  • Added Element
Measure.group.stratifier.description
  • Added Element
Measure.supplementalData.code
  • Added Element
Measure.supplementalData.description
  • Added Element
Measure.group.identifier
  • deleted
Measure.group.name
  • deleted
Measure.group.population.identifier
  • deleted
Measure.group.population.name
  • deleted
Measure.group.stratifier.identifier
  • deleted
Measure.supplementalData.identifier
  • deleted

This resource did not exist in Release 2 See the Full Difference for further information

This analysis is available as XML or JSON .

Structure

1..1
Name Flags Card. Type Description & Constraints doco
. . Measure TU DomainResource A quality measure definition
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . url Σ 0..1 uri Logical URI to reference Canonical identifier for this measure measure, represented as a URI (globally unique)
. . . identifier Σ 0..* Identifier Additional identifier for the measure
. . . version Σ 0..1 string Business version of the measure
. . . name Σ 0..1 string Name for this measure (computer friendly)
. . . title Σ 0..1 string Name for this measure (human friendly)
. . . subtitle 0..1 string Subordinate title of the measure
... status ?! Σ 1..1 code draft | active | retired | unknown
PublicationStatus ( Required )
. . . experimental ?! Σ 0..1 boolean For testing purposes, not real usage
. . . subject[x] 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
SubjectType ( Extensible )
.... subjectCodeableConcept CodeableConcept
.... subjectReference Reference ( Group )
. . . date Σ 0..1 dateTime Date this was last changed
. . . publisher Σ 0..1 string Name of the publisher (organization or individual)
. . description . contact Σ 0..1 0..* markdown ContactDetail Natural language description of Contact details for the measure publisher
. . . purpose description Σ 0..1 markdown Why this Natural language description of the measure is defined
. . usage . useContext Σ 0..1 0..* string UsageContext Describes the clinical usage of The context that the measure content is intended to support
. . approvalDate . jurisdiction Σ 0..1 0..* date CodeableConcept When the Intended jurisdiction for measure was approved by publisher (if applicable)
Jurisdiction ValueSet ( Extensible )
. . . lastReviewDate purpose 0..1 date markdown When the Why this measure was last reviewed is defined
. . effectivePeriod . usage Σ 0..1 Period string When Describes the clinical usage of the measure is expected to be used
. . useContext . copyright Σ 0..* 0..1 UsageContext markdown Context the content is intended to support Use and/or publishing restrictions
. . jurisdiction . approvalDate Σ 0..* 0..1 CodeableConcept date Intended jurisdiction for When the measure (if applicable) Jurisdiction ValueSet ( Extensible ) was approved by publisher
. . topic . lastReviewDate 0..* 0..1 CodeableConcept date E.g. Education, Treatment, Assessment, etc DefinitionTopic ( Example ) When the measure was last reviewed
. . . contributor effectivePeriod Σ 0..* 0..1 Contributor Period A content contributor When the measure is expected to be used
. . . contact topic Σ 0..* ContactDetail CodeableConcept Contact details for The category of the publisher measure, such as Education, Treatment, Assessment, etc.
DefinitionTopic ( Example )
. . copyright . contributor 0..1 0..* markdown Contributor Use and/or publishing restrictions A content contributor
. . . relatedArtifact 0..* RelatedArtifact Additional documentation, citations, etc etc.
. . . library 0..* Reference ( Library canonical ) Logic used by the measure
. . . disclaimer Σ 0..1 markdown Disclaimer for use of the measure or its referenced content
. . . scoring Σ 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
MeasureScoring ( Extensible )
. . . compositeScoring Σ 0..1 CodeableConcept opportunity | all-or-nothing | linear | weighted
CompositeMeasureScoring ( Extensible )
. . . type Σ 0..* CodeableConcept process | outcome | structure | patient-reported-outcome | composite
MeasureType ( Extensible )
. . . riskAdjustment Σ 0..1 string How is risk adjustment is applied for this measure
. . . rateAggregation Σ 0..1 string How is rate aggregation performed for this measure
. . . rationale Σ 0..1 markdown Why does this measure exist
. . . clinicalRecommendationStatement Σ 0..1 markdown Summary of clinical guidelines
. . . improvementNotation Σ 0..1 string Improvement notation for the measure, e.g. higher score indicates better quality
. . . definition Σ 0..* markdown Defined terms used in the measure documentation
. . . guidance Σ 0..1 markdown Additional guidance for implementers
. . . set Σ 0..1 string The measure set, e.g. Preventive Care and Screening
. . . group 0..* BackboneElement Population criteria group
. . . . identifier code Identifier Unique identifier name 0..1 string CodeableConcept Short name Meaning of the group
. . . . description 0..1 string Summary description
. . . . population 0..* BackboneElement Population criteria
. . . . . identifier 0..1 Identifier Unique identifier code 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
MeasurePopulationType ( Extensible )
. . . . . name 0..1 string Short name description 0..1 string The human readable description of this population criteria
. . . . . criteria 1..1 string The name of a valid referenced CQL expression (may be namespaced) that defines this population criteria
. . . . stratifier 0..* BackboneElement Stratifier criteria for the measure
. . . . . identifier code 0..1 Identifier CodeableConcept The identifier for Meaning of the stratifier used to coordinate the reported data back to
. . . . . description 0..1 string The human readable description of this stratifier
. . . . . criteria 0..1 string How the measure should be stratified
. . . . . path 0..1 string Path to the stratifier
. . . supplementalData 0..* BackboneElement What other data should be reported with the measure
. . . . identifier code 0..1 Identifier CodeableConcept Identifier, unique within Meaning of the measure supplemental data
. . . . usage 0..* CodeableConcept supplemental-data | risk-adjustment-factor
MeasureDataUsage ( Extensible )
. . . . description 0..1 string The human readable description of this supplemental data
.... criteria 0..1 string Expression describing additional data to be reported
. . . . path 0..1 string Path to the supplemental data element

doco Documentation for this format

UML Diagram ( Legend )

Measure ( DomainResource ) An absolute URI that is used to identify this measure when it is referenced in a specification, model, design or an instance. instance; also called its canonical identifier. This SHALL be a URL, SHOULD be globally unique, unique and SHOULD be an a literal address at which this measure is (or will be) published. The URL SHOULD include the major version of the measure. For more information see [Technical and Business Versions](resource.html#versions) published 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] 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] 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] « The lifecycle status of a Value Set or Concept Map. an artifact. (Strength=Required) PublicationStatus ! » A boolean Boolean value to indicate that this measure is authored for testing purposes (or education/evaluation/marketing), education/evaluation/marketing) and is not intended to be used for genuine usage (this element modifies the meaning of other elements) 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] : Type [0..1] « CodeableConcept | Reference ( Group ); The possible types of subjects for a measure (E.g. Patient, Practitioner, Organization, Location, etc.) (Strength=Extensible) SubjectType + » The date (and optionally time) when the measure was published. The date must change if and when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the measure changes date : dateTime [0..1] The name of the individual or organization or individual that published 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 terms 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 is intended to be used jurisdiction : CodeableConcept [0..*] « Countries and regions within which this artifact is targeted for use (Strength=Extensible) Jurisdiction ValueSet + » Explaination Explanation of why this measure is needed and why it has been designed as it has purpose : markdown [0..1] A detailed description description, from a clinical perspective, of how the measure is used from a clinical perspective usage : string [0..1] A copyright statement relating to the measure and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the measure copyright : markdown [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, approval but doesn't 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 content was developed with a focus and intent of supporting the contexts that are listed. These terms 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 is intended to be used jurisdiction : CodeableConcept [0..*] Countries and regions within which this artifact is targeted for use (Strength=Extensible) Jurisdiction ValueSet + Descriptive topics related to the content of the measure. Topics provide a high-level categorization grouping types of the type of the measure measures that can be useful for filtering and searching topic : CodeableConcept [0..*] « High-level categorization of the definition, used for searching, sorting, and filtering (Strength=Example) DefinitionTopic ?? » A contributor to the content of the measure, including authors, editors, reviewers, and endorsers contributor : Contributor [0..*] Contact details to assist a user in finding and communicating with the publisher contact : ContactDetail [0..*] A copyright statement relating to the measure and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the measure copyright : markdown [0..1] 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 : Reference canonical [0..*] Library Notices and disclaimers regarding the use of the measure, measure or related to intellectual property (such as code systems) referenced by the measure disclaimer : markdown [0..1] Indicates how the calculation is performed for the measure, including proportion, ratio, continuous variable, continuous-variable, and cohort. The value set is extensible, allowing additional measure scoring types to be represented scoring : CodeableConcept [0..1] « The scoring type of the measure (Strength=Extensible) MeasureScoring + » If this is a composite measure, the scoring method used to combine the component measures to determine the composite score compositeScoring : CodeableConcept [0..1] « The composite scoring method of the measure (Strength=Extensible) CompositeMeasureScoring + » 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..*] « The type of measure (includes codes from 2.16.840.1.113883.1.11.20368) (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 : string [0..1] Describes how to combine the information calculated, based on logic in each of several populations, into one summarized result rateAggregation : string [0..1] Provides a succint succinct statement of the need for the measure. Usually includes 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] Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is whthin within a range) improvementNotation : string [0..1] Provides a description of an individual term used within the measure definition : markdown [0..*] 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] The measure set, e.g. Preventive Care and Screening set : string [0..1] Group A unique identifier Indicates a meaning for the group. This identifier will used to report data for the group in the measure report identifier : Identifier [1..1] Optional name can be as simple as a unique identifier, or short description of this group it can establish meaning in a broader context by drawing from a terminology, allowing groups to be correlated across measures name code : string CodeableConcept [0..1] The human readable description of this population group description : string [0..1] Population A unique identifier for the population criteria. This identifier is used to report data against this criteria within the measure report identifier : Identifier [0..1] The type of population criteria code : CodeableConcept [0..1] « The type of population (Strength=Extensible) MeasurePopulationType + » Optional name or short description of this population name : string [0..1] The human readable description of this population criteria description : string [0..1] The name of a valid referenced CQL expression (may be namespaced) that defines this population criteria criteria : string [1..1] Stratifier The identifier Indicates a meaning for the stratifier used to coordinate the reported data back 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] The human readable description of this stratifier criteria identifier description : Identifier string [0..1] The criteria for the stratifier. This must be the name of an expression defined within a referenced library criteria : string [0..1] The path to an element that defines the stratifier, specified as a valid FHIR resource path path : string [0..1] SupplementalData An identifier 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 identifier code : Identifier CodeableConcept [0..1] 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..*] « The intended usage for supplemental data elements in the measure (Strength=Extensible) MeasureDataUsage + » The human readable description of this supplemental data description : string [0..1] The criteria for the supplemental data. This must be the name of a valid expression defined within a referenced library, and library. The criteria defines the data to be returned for this element criteria : string [0..1] The supplemental data to be supplied as part of the measure response, specified as a valid FHIR Resource Path path : string [0..1] A population criteria for the measure population [0..*] The stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library, library or a valid FHIR Resource Path 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>
 <
 <
 <
 <
 <
 <
 <
 <
 <
 <
 <
 <
 <</effectivePeriod>
 <</useContext>

 <version value="[string]"/><!-- 0..1 Business version of the measure -->
 <name value="[string]"/><!-- 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 purposes, not 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 (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><!-- 0..* CodeableConcept Intended jurisdiction for measure (if applicable) --></jurisdiction>
 <</topic>

 <purpose value="[markdown]"/><!-- 0..1 Why this measure is defined -->
 <usage value="[string]"/><!-- 0..1 Describes the clinical usage of the measure -->
 <copyright value="[markdown]"/><!-- 0..1 Use and/or publishing restrictions -->
 <approvalDate value="[date]"/><!-- 0..1 When the measure was approved by publisher -->
 <lastReviewDate value="[date]"/><!-- 0..1 When the measure was last reviewed -->
 <effectivePeriod><!-- 0..1 Period When the measure is expected to be used --></effectivePeriod>
 <topic><!-- 0..* CodeableConcept The category of the measure, such as Education, Treatment, Assessment, etc. --></topic>

 <contributor><!-- 0..* Contributor A content contributor --></contributor>
 <</contact>
 <
 <</relatedArtifact>
 <</library>
 <
 <</scoring>

 <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><!-- 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort --></scoring>

 <compositeScoring><!-- 0..1 CodeableConcept opportunity | all-or-nothing | linear | weighted --></compositeScoring>
 <type><!-- 0..* CodeableConcept process | outcome | structure | patient-reported-outcome | composite --></type>
 <
 <
 <
 <
 <
 <
 <
 <

 <riskAdjustment value="[string]"/><!-- 0..1 How risk adjustment is applied for this measure -->
 <rateAggregation value="[string]"/><!-- 0..1 How is rate aggregation performed for this measure -->
 <rationale value="[markdown]"/><!-- 0..1 Why does this measure exist -->
 <clinicalRecommendationStatement value="[markdown]"/><!-- 0..1 Summary of clinical guidelines -->
 <improvementNotation value="[string]"/><!-- 0..1 Improvement notation for the measure, e.g. higher score indicates better quality -->
 <definition value="[markdown]"/><!-- 0..* Defined terms used in the measure documentation -->
 <guidance value="[markdown]"/><!-- 0..1 Additional guidance for implementers -->
 <set value="[string]"/><!-- 0..1 The measure set, e.g. Preventive Care and Screening -->

 <group>  <!-- 0..* Population criteria group -->
  <</identifier>
  <
  <

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

  <population>  <!-- 0..* Population criteria -->
   <</identifier>

   <code><!-- 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation --></code>
   <
   <
   <

   <description value="[string]"/><!-- 0..1 The human readable description of this population criteria -->
   <criteria value="[string]"/><!-- 1..1 The name of a valid referenced CQL expression (may be namespaced) that defines this population criteria -->

  </population>
  <
   <</identifier>
   <
   <

  <stratifier>  <!-- 0..* Stratifier criteria for the measure -->
   <code><!-- 0..1 CodeableConcept Meaning of the stratifier --></code>
   <description value="[string]"/><!-- 0..1 The human readable description of this stratifier -->
   <criteria value="[string]"/><!-- 0..1 How the measure should be stratified -->
   <path value="[string]"/><!-- 0..1 Path to the stratifier -->

  </stratifier>
 </group>
 <supplementalData>  <!-- 0..* What other data should be reported with the measure -->
  <</identifier>

  <code><!-- 0..1 CodeableConcept Meaning of the supplemental data --></code>

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

  <description value="[string]"/><!-- 0..1 The human readable description of this supplemental data -->
  <criteria value="[string]"/><!-- 0..1 Expression describing additional data to be reported -->
  <path value="[string]"/><!-- 0..1 Path to the supplemental data element -->

 </supplementalData>
</Measure>

JSON Template 

{doco
  "resourceType" : "",

  "resourceType" : "Measure",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
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  "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
  "name" : "<string>", // 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 purposes, not 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 (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 }], // Intended jurisdiction for measure (if applicable)
  "purpose" : "<markdown>", // Why this measure is defined
  "usage" : "<string>", // Describes the clinical usage of the measure
  "copyright" : "<markdown>", // Use and/or publishing restrictions
  "approvalDate" : "<date>", // When the measure was approved by publisher
  "lastReviewDate" : "<date>", // When the measure was last reviewed
  "effectivePeriod" : { Period }, // When the measure is expected to be used
  "topic" : [{ CodeableConcept }], // The category of the measure, such as Education, Treatment, Assessment, etc.
  "contributor" : [{ Contributor }], // A content contributor
  "relatedArtifact" : [{ RelatedArtifact }], // Additional documentation, citations, etc.
  "library" : ["<canonical>"], // Logic used by the measure
  "disclaimer" : "<markdown>", // Disclaimer for use of the measure or its referenced content
  "scoring" : { CodeableConcept }, // proportion | ratio | continuous-variable | cohort
  "compositeScoring" : { CodeableConcept }, // opportunity | all-or-nothing | linear | weighted
  "type" : [{ CodeableConcept }], // process | outcome | structure | patient-reported-outcome | composite
  "riskAdjustment" : "<string>", // How risk adjustment is applied for this measure
  "rateAggregation" : "<string>", // How is rate aggregation performed for this measure
  "rationale" : "<markdown>", // Why does this measure exist
  "clinicalRecommendationStatement" : "<markdown>", // Summary of clinical guidelines
  "improvementNotation" : "<string>", // Improvement notation for the measure, e.g. higher score indicates better quality
  "definition" : ["<markdown>"], // Defined terms used in the measure documentation
  "guidance" : "<markdown>", // Additional guidance for implementers
  "set" : "<string>", // The measure set, e.g. Preventive Care and Screening
  "group" : [{ // Population criteria group
    "code" : { CodeableConcept }, // Meaning of the group
    "description" : "<string>", // Summary description
    "population" : [{ // Population criteria
      "code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      "description" : "<string>", // The human readable description of this population criteria
      "criteria" : "<string>" // R!  The name of a valid referenced CQL expression (may be namespaced) that defines this population criteria

    }],
    "
      "
      "
      "

    "stratifier" : [{ // Stratifier criteria for the measure
      "code" : { CodeableConcept }, // Meaning of the stratifier
      "description" : "<string>", // The human readable description of this stratifier
      "criteria" : "<string>", // How the measure should be stratified
      "path" : "<string>" // Path to the stratifier

    }]
  }],
  "
    "
    "
    "
    "

  "supplementalData" : [{ // What other data should be reported with the measure
    "code" : { CodeableConcept }, // Meaning of the supplemental data
    "usage" : [{ CodeableConcept }], // supplemental-data | risk-adjustment-factor
    "description" : "<string>", // The human readable description of this supplemental data
    "criteria" : "<string>", // Expression describing additional data to be reported
    "path" : "<string>" // Path to the supplemental data element

  }]
}

Turtle Template 

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


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

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

  fhir:Measure.url [ uri ]; # 0..1 Canonical identifier for this measure, represented as a URI (globally unique)

  fhir:Measure.identifier [ Identifier ], ... ; # 0..* Additional identifier for the measure
  fhir:Measure.version [ string ]; # 0..1 Business version of the measure
  fhir:Measure.name [ string ]; # 0..1 Name for this measure (computer friendly)
  fhir:Measure.title [ string ]; # 0..1 Name for this measure (human friendly)
  fhir:Measure.subtitle [ string ]; # 0..1 Subordinate title of the measure

  fhir:Measure.status [ code ]; # 1..1 draft | active | retired | unknown
  fhir:
  fhir:
  fhir:

  fhir:Measure.experimental [ boolean ]; # 0..1 For testing purposes, not real usage
  # Measure.subject[x] : 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2
    fhir:Measure.subjectCodeableConcept [ CodeableConcept ]
    fhir:Measure.subjectReference [ Reference(Group) ]
  fhir:Measure.date [ dateTime ]; # 0..1 Date last changed
  fhir:Measure.publisher [ string ]; # 0..1 Name of the publisher (organization or individual)
  fhir:Measure.contact [ ContactDetail ], ... ; # 0..* Contact details for the publisher

  fhir:Measure.description [ markdown ]; # 0..1 Natural language description of the measure
  fhir:
  fhir:

  fhir:Measure.useContext [ UsageContext ], ... ; # 0..* The context that the content is intended to support
  fhir:Measure.jurisdiction [ CodeableConcept ], ... ; # 0..* Intended jurisdiction for measure (if applicable)
  fhir:Measure.purpose [ markdown ]; # 0..1 Why this measure is defined
  fhir:Measure.usage [ string ]; # 0..1 Describes the clinical usage of the measure
  fhir:Measure.copyright [ markdown ]; # 0..1 Use and/or publishing restrictions

  fhir:Measure.approvalDate [ date ]; # 0..1 When the measure was approved by publisher
  fhir:

  fhir:Measure.lastReviewDate [ date ]; # 0..1 When the measure was last reviewed

  fhir:Measure.effectivePeriod [ Period ]; # 0..1 When the measure is expected to be used
  fhir:
  fhir:
  fhir:

  fhir:Measure.topic [ CodeableConcept ], ... ; # 0..* The category of the measure, such as Education, Treatment, Assessment, etc.

  fhir:Measure.contributor [ Contributor ], ... ; # 0..* A content contributor
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:

  fhir:Measure.relatedArtifact [ RelatedArtifact ], ... ; # 0..* Additional documentation, citations, etc.
  fhir:Measure.library [ canonical(Library) ], ... ; # 0..* Logic used by the measure
  fhir:Measure.disclaimer [ markdown ]; # 0..1 Disclaimer for use of the measure or its referenced content
  fhir:Measure.scoring [ CodeableConcept ]; # 0..1 proportion | ratio | continuous-variable | cohort

  fhir:Measure.compositeScoring [ CodeableConcept ]; # 0..1 opportunity | all-or-nothing | linear | weighted
  fhir:Measure.type [ CodeableConcept ], ... ; # 0..* process | outcome | structure | patient-reported-outcome | composite
  fhir:

  fhir:Measure.riskAdjustment [ string ]; # 0..1 How risk adjustment is applied for this measure

  fhir:Measure.rateAggregation [ string ]; # 0..1 How is rate aggregation performed for this measure
  fhir:

  fhir:Measure.rationale [ markdown ]; # 0..1 Why does this measure exist

  fhir:Measure.clinicalRecommendationStatement [ markdown ]; # 0..1 Summary of clinical guidelines
  fhir:

  fhir:Measure.improvementNotation [ string ]; # 0..1 Improvement notation for the measure, e.g. higher score indicates better quality

  fhir:Measure.definition [ markdown ], ... ; # 0..* Defined terms used in the measure documentation
  fhir:Measure.guidance [ markdown ]; # 0..1 Additional guidance for implementers
  fhir:Measure.set [ string ]; # 0..1 The measure set, e.g. Preventive Care and Screening
  fhir:Measure.group [ # 0..* Population criteria group
    fhir:
    fhir:

    fhir:Measure.group.code [ CodeableConcept ]; # 0..1 Meaning of the group

    fhir:Measure.group.description [ string ]; # 0..1 Summary description
    fhir:Measure.group.population [ # 0..* Population criteria
      fhir:

      fhir:Measure.group.population.code [ CodeableConcept ]; # 0..1 initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      fhir:

      fhir:Measure.group.population.description [ string ]; # 0..1 The human readable description of this population criteria
      fhir:Measure.group.population.criteria [ string ]; # 1..1 The name of a valid referenced CQL expression (may be namespaced) that defines this population criteria
    ], ...;
    fhir:
      fhir:

    fhir:Measure.group.stratifier [ # 0..* Stratifier criteria for the measure
      fhir:Measure.group.stratifier.code [ CodeableConcept ]; # 0..1 Meaning of the stratifier
      fhir:Measure.group.stratifier.description [ string ]; # 0..1 The human readable description of this stratifier

      fhir:Measure.group.stratifier.criteria [ string ]; # 0..1 How the measure should be stratified
      fhir:Measure.group.stratifier.path [ string ]; # 0..1 Path to the stratifier
    ], ...;
  ], ...;
  fhir:Measure.supplementalData [ # 0..* What other data should be reported with the measure
    fhir:

    fhir:Measure.supplementalData.code [ CodeableConcept ]; # 0..1 Meaning of the supplemental data

    fhir:Measure.supplementalData.usage [ CodeableConcept ], ... ; # 0..* supplemental-data | risk-adjustment-factor
    fhir:

    fhir:Measure.supplementalData.description [ string ]; # 0..1 The human readable description of this supplemental data
    fhir:Measure.supplementalData.criteria [ string ]; # 0..1 Expression describing additional data to be reported

    fhir:Measure.supplementalData.path [ string ]; # 0..1 Path to the supplemental data element
  ], ...;
]

Changes since DSTU2

Measure
Measure.subtitle
  • Added Element
Measure.subject[x]
  • Added Element
Measure.library
  • Type changed from Reference(Library) to canonical
Measure.group.code
  • Added Element
Measure.group.stratifier.code
  • Added Element
Measure.group.stratifier.description
  • Added Element
Measure.supplementalData.code
  • Added Element
Measure.supplementalData.description
  • Added Element
Measure.group.identifier
  • deleted
Measure.group.name
  • deleted
Measure.group.population.identifier
  • deleted
Measure.group.population.name
  • deleted
Measure.group.stratifier.identifier
  • deleted
Measure.supplementalData.identifier
  • deleted

This resource did not exist in Release 2 See the Full Difference for further information

This analysis is available as XML or JSON .

 

Alternate definitions: Master Definition ( XML , + JSON ), , XML Schema / Schematron (for ) + JSON Schema , ShEx (for Turtle ) + see the extensions & the dependency analysis

14.5.3.1 14.11.3.1 Terminology Bindings

Path Definition Type Reference
Measure.status The lifecycle status of a Value Set or Concept Map. an artifact. Required PublicationStatus
Measure.subject[x] The possible types of subjects for a measure (E.g. Patient, Practitioner, Organization, Location, etc.) Extensible SubjectType
Measure.jurisdiction Countries and regions within which this artifact is targeted for use Extensible Jurisdiction ValueSet
Measure.topic High-level categorization of the definition, used for searching, sorting, and filtering Example DefinitionTopic
Measure.scoring The scoring type of the measure Extensible MeasureScoring
Measure.compositeScoring The composite scoring method of the measure Extensible CompositeMeasureScoring
Measure.type The type of measure (includes codes from 2.16.840.1.113883.1.11.20368) Extensible MeasureType
Measure.group.population.code The type of population Extensible MeasurePopulationType
Measure.supplementalData.usage The intended usage for supplemental data elements in the measure Extensible MeasureDataUsage

14.5.4 14.11.4 Search Parameters

Search parameters for 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)
date date The measure publication date Measure.date
depends-on reference What resource is being referenced Measure.relatedArtifact.where(type='depends-on').resource | Measure.library
( Library , Any) )
derived-from reference What resource is being referenced Measure.relatedArtifact.where(type='derived-from').resource (Any)
description string The description of the measure Measure.description
effective date The time during which the measure is intended to be in use Measure.effectivePeriod
identifier token External identifier for the measure Measure.identifier
jurisdiction token Intended jurisdiction for the measure Measure.jurisdiction
name string Computationally friendly name of the measure Measure.name
predecessor reference What resource is being referenced Measure.relatedArtifact.where(type='predecessor').resource (Any)
publisher string Name of the publisher of the measure Measure.publisher
status token The current status of the measure Measure.status
successor reference What resource is being referenced Measure.relatedArtifact.where(type='successor').resource (Any)
title string The human-friendly name of the measure Measure.title
topic token Topics associated with the module measure Measure.topic
url uri The uri that identifies the measure Measure.url
version token The business version of the measure Measure.version