FHIR Release 3 (STU) 4

This page is part of the FHIR Specification (v3.0.2: (v4.0.1: R4 - Mixed Normative and STU 3). ) in it's permanent home (it will always be available at this URL). 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 R4 R3 R2

14.6 14.15 Resource MeasureReport - Content

Clinical Quality Information Work Group Maturity Level : 2   Trial Use Security Category : Business Compartments : Patient

The MeasureReport resource contains the results of evaluating the calculation of a measure. measure; and optionally a reference to the resources involved in that calculation.

14.6.1 14.15.1 Scope and Usage

This resource is an event resource from a FHIR workflow perspective - see Workflow , specifically Event . The MeasureReport resource represents the results of evaluating calculating a measure for a specific patient subject or group of patients. subjects. The $evaluate-measure operation of the Measure resource is defined to return a MeasureReport. The resource is capable of representing three different levels of report: patient-level, patient-list, individual, subject-list, and summary.

The resource draws requirements from the HL7 CDA R2 Implementation Guide: Quality Reporting Document Architecture - Category 1 (QRDA I) DSTU Release 3 (US Realm) and the HL7 Implementation Guide for CDA Release 2: Quality Reporting Document Architecture - Category III (QRDA III), DSTU Release 1 implementation guides.

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

Note that this resource is a special case of the more general notion of a query evaluation result. However, because the general case requires the ability to represent arbitrary content, this resource uses a simple indicator structure to describe population sizes for each population type defined in the measure. The intent is to be able to represent the more general case as well, either by generalizing this resource, or by making this structure a profile of a more general resource, and we are actively seeking comments about what approaches might be taken to achieve that aim.

14.6.2 14.15.2 Boundaries and Relationships

Although the MeasureReport is conceptually an Observation , there is enough specific information required to support the quality reporting use case to warrant a separate resource.

The resource is differentiated from a general purpose query result because it communicates specific information related to quality measurement evaluation that would be difficult to convey generally without imposing some other structure on top of the general results.

14.6.3 14.15.3 Resource Content

Structure

0..1 BackboneElement Measure results for each group BackboneElement The populations in Population results in this stratum Identifier Σ
Name Flags Card. Type Description & Constraints doco
. . MeasureReport I TU DomainResource Results of a measure evaluation
+ Rule: Measure Reports used for data collection SHALL NOT communicate group and score information
+ Rule: Stratifiers SHALL be either a single criteria or a set of criteria components
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier Additional identifier for the Report MeasureReport
. . . status ?! Σ 1..1 code complete | pending | error
MeasureReportStatus ( Required )
. . . type Σ I 1..1 code individual | patient-list subject-list | summary | data-collection
MeasureReportType ( Required )
. . . measure Σ 1..1 Reference canonical ( Measure ) What measure was evaluated calculated
. . patient . subject Σ 0..1 Reference ( Patient | Practitioner | PractitionerRole | Location | Device | RelatedPerson | Group ) What patient individual(s) the report is for
. . . date Σ 0..1 dateTime When the report was generated
. . reportingOrganization . reporter Σ 0..1 Reference ( Practitioner | PractitionerRole | Location | Organization ) Who is reporting the data
. . . period Σ 1..1 Period What period the report covers
. . group . improvementNotation ?! Σ 0..* 0..1 CodeableConcept increase | decrease
MeasureImprovementNotation ( Required )
. . identifier . group I 1..1 0..* Identifier BackboneElement What Measure results for each group of the measure
. . . population . code Σ 0..* 0..1 CodeableConcept Meaning of the group
. . . identifier . population Σ 0..1 0..* Identifier BackboneElement Population identifier as defined The populations in the measure group
. . . . . code Σ 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-score measure-observation
MeasurePopulationType ( Extensible )
. . . . . count 0..1 integer Size of the population
. . . . patients . subjectResults 0..1 Reference ( List ) For patient-list subject-list reports, the patients subject results in this population
. . . . measureScore Σ 0..1 decimal Quantity What score this group achieved
. . . . stratifier 0..* BackboneElement Stratification results
. . . . . identifier code 0..1 0..* Identifier CodeableConcept What stratifier of the group
. . . . . stratum 0..* BackboneElement Stratum results, one for each unique value value, or set of values, in the stratifier, or stratifier components
. . . . . . value 1..1 0..1 string CodeableConcept The stratum value, e.g. male
. . . . . population . component 0..* BackboneElement Stratifier component values
. . . . . . . identifier code Σ 1..1 0..1 CodeableConcept What stratifier component of the group
. . . . . . . value 1..1 CodeableConcept The stratum component value, e.g. male
...... population 0..* BackboneElement Population identifier as defined results in the measure this stratum
. . . . . . . code 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-score measure-observation
MeasurePopulationType ( Extensible )
. . . . . . . count 0..1 integer Size of the population
. . . . . . patients . subjectResults 0..1 Reference ( List ) For patient-list subject-list reports, the patients subject results in this population
. . . . . . measureScore Σ 0..1 decimal Quantity What score this stratum achieved
. . evaluatedResources . evaluatedResource 0..1 0..* Reference ( Bundle Any ) What data was evaluated used to produce calculate the measure score

doco Documentation for this format

UML Diagram ( Legend )

MeasureReport ( DomainResource ) A formal identifier that is used to identify this report MeasureReport when it is represented in other formats, formats or referenced in a specification, model, design or an instance identifier : Identifier [0..1] [0..*] The report MeasureReport status. No data will be available until the report MeasureReport status is complete (this element modifies the meaning of other elements) status : code [1..1] « The status of the measure report report. (Strength=Required) MeasureReportStatus ! » The type of measure report. This may be an individual report, which provides a single patient's the score for the measure; measure for an individual member of the population; a patient listing, subject-listing, which returns the list of patients members that meet the various criteria in the measure; or a summary report, which returns a population count for each of the criteria in the measure; or a data-collection, which enables the MeasureReport to be used to exchange the data-of-interest for a quality measure type : code [1..1] « The type of the measure report report. (Strength=Required) MeasureReportType ! » A reference to the Measure that was evaluated calculated to produce this report measure : Reference canonical [1..1] « Measure » Optional Patient if subject identifying the individual or individuals the report was requested is for a single patient patient subject : Reference [0..1] « Patient | Practitioner | PractitionerRole | Location | Device | RelatedPerson | Group » The date this measure report was generated date : dateTime [0..1] Reporting Organization The individual, location, or organization that is reporting the data reportingOrganization reporter : Reference [0..1] « Practitioner | PractitionerRole | Location | Organization » The reporting period for which the report was calculated period : Period [1..1] Whether improvement in the measure is noted by an increase or decrease in the measure score (this element modifies the meaning of other elements) improvementNotation : CodeableConcept [0..1] « Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue. (Strength=Required) MeasureImprovementNotation ! » A reference to a Bundle containing the Resources that were used in the evaluation calculation of this report measure evaluatedResources evaluatedResource : Reference [0..1] Bundle [0..*] « Any » Group The identifier meaning of the population group as defined in the measure definition identifier code : Identifier CodeableConcept [1..1] [0..1] The measure score for this population group, calculated as appropriate for the measure type and scoring method, and based on the contents of the populations defined in the group measureScore : decimal Quantity [0..1] Population The identifier of the population being reported, as defined by the population element of the measure identifier : Identifier [0..1] Population The type of the population code : CodeableConcept [0..1] « The type of population (e.g. initial, numerator, denominator, etc.) etc.). (Strength=Extensible) MeasurePopulationType + » The number of members of the population count : integer [0..1] This element refers to a List of patient subject level MeasureReport resources, one for each patient subject in this population patients subjectResults : Reference [0..1] « List » Stratifier The identifier meaning of this stratifier, as defined in the measure definition identifier code : Identifier CodeableConcept [0..1] [0..*] StratifierGroup The value for this stratum, expressed as a string. CodeableConcept. When defining stratifiers on complex values, the value must be rendered such that the value for each stratum within the stratifier is unique value : string CodeableConcept [1..1] [0..1] The measure score for this stratum, calculated as appropriate for the measure type and scoring method, and based on only the members of this stratum measureScore : decimal Quantity [0..1] StratifierGroupPopulation Component The identifier of the population being reported, as defined by the population element of code for the measure stratum component value identifier code : Identifier CodeableConcept [0..1] [1..1] The stratum component value value : CodeableConcept [1..1] StratifierGroupPopulation The type of the population code : CodeableConcept [0..1] « The type of population (e.g. initial, numerator, denominator, etc.) etc.). (Strength=Extensible) MeasurePopulationType + » The number of members of the population in this stratum count : integer [0..1] This element refers to a List of patient subject level MeasureReport resources, one for each patient subject in this population in this stratum patients subjectResults : Reference [0..1] « List » The populations that make up the population group, one for each type of population appropriate for the measure population [0..*] A stratifier component value component [0..*] The populations that make up the stratum, one for each type of population appropriate to the measure population [0..*] This element contains the results for a single stratum within the stratifier. For example, when stratifying on administrative gender, there will be four strata, one for each possible gender value stratum [0..*] When a measure includes multiple stratifiers, there will be a stratifier group for each stratifier defined by the measure stratifier [0..*] The results of the calculation, one for each population group in the measure group [0..*]

XML Template 

<

<MeasureReport xmlns="http://hl7.org/fhir"> doco

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <</identifier>
 <
 <
 <</measure>
 <</patient>
 <
 <</reportingOrganization>

 <identifier><!-- 0..* Identifier Additional identifier for the MeasureReport --></identifier>
 <status value="[code]"/><!-- 1..1 complete | pending | error -->
 <type value="[code]"/><!-- ?? 1..1 individual | subject-list | summary | data-collection -->
 <measure><!-- 1..1 canonical(Measure) What measure was calculated --></measure>
 <subject><!-- 0..1 Reference(Patient|Practitioner|PractitionerRole|Location|
   Device|RelatedPerson|Group) What individual(s) the report is for --></subject>

 <date value="[dateTime]"/><!-- 0..1 When the report was generated -->
 <reporter><!-- 0..1 Reference(Practitioner|PractitionerRole|Location|
   Organization) Who is reporting the data --></reporter>
 <period><!-- 1..1 Period What period the report covers --></period>
 <
  <</identifier>

 <improvementNotation><!-- 0..1 CodeableConcept increase | decrease --></improvementNotation>
 <group>  <!-- ?? 0..* Measure results for each group -->
  <code><!-- 0..1 CodeableConcept Meaning of the group --></code>

  <population>  <!-- 0..* The populations in the group -->
   <</identifier>
   <</code>
   <
   <</patients>

   <code><!-- 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation --></code>
   <count value="[integer]"/><!-- 0..1 Size of the population -->
   <subjectResults><!-- 0..1 Reference(List) For subject-list reports, the subject results in this population --></subjectResults>

  </population>
  <

  <measureScore><!-- 0..1 Quantity What score this group achieved --></measureScore>

  <stratifier>  <!-- 0..* Stratification results -->
   <</identifier>
   <
    <

   <code><!-- 0..* CodeableConcept What stratifier of the group --></code>
   <stratum>  <!-- 0..* Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components -->
    <value><!-- 0..1 CodeableConcept The stratum value, e.g. male --></value>
    <component>  <!-- 0..* Stratifier component values -->
     <code><!-- 1..1 CodeableConcept What stratifier component of the group --></code>
     <value><!-- 1..1 CodeableConcept The stratum component value, e.g. male --></value>
    </component>

    <population>  <!-- 0..* Population results in this stratum -->
     <</identifier>
     <</code>
     <
     <</patients>

     <code><!-- 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation --></code>
     <count value="[integer]"/><!-- 0..1 Size of the population -->
     <subjectResults><!-- 0..1 Reference(List) For subject-list reports, the subject results in this population --></subjectResults>

    </population>
    <

    <measureScore><!-- 0..1 Quantity What score this stratum achieved --></measureScore>

   </stratum>
  </stratifier>
 </group>
 <</evaluatedResources>

 <evaluatedResource><!-- 0..* Reference(Any) What data was used to calculate the measure score --></evaluatedResource>

</MeasureReport>

JSON Template 

{doco
  "resourceType" : "",

  "resourceType" : "MeasureReport",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "
  "
  "
  "
  "
  "
  "
  "
  "
    "
    "
      "
      "
      "
      "

  "identifier" : [{ Identifier }], // Additional identifier for the MeasureReport
  "status" : "<code>", // R!  complete | pending | error
  "type" : "<code>", // C? R!  individual | subject-list | summary | data-collection
  "measure" : { canonical(Measure) }, // R!  What measure was calculated
  "subject" : { Reference(Patient|Practitioner|PractitionerRole|Location|
   Device|RelatedPerson|Group) }, // What individual(s) the report is for

  "date" : "<dateTime>", // When the report was generated
  "reporter" : { Reference(Practitioner|PractitionerRole|Location|
   Organization) }, // Who is reporting the data

  "period" : { Period }, // R!  What period the report covers
  "improvementNotation" : { CodeableConcept }, // increase | decrease
  "group" : [{ // C? Measure results for each group
    "code" : { CodeableConcept }, // Meaning of the group
    "population" : [{ // The populations in the group
      "code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      "count" : <integer>, // Size of the population
      "subjectResults" : { Reference(List) } // For subject-list reports, the subject results in this population

    }],
    "
    "
      "
      "
        "
        "
          "
          "
          "
          "

    "measureScore" : { Quantity }, // What score this group achieved
    "stratifier" : [{ // Stratification results
      "code" : [{ CodeableConcept }], // What stratifier of the group
      "stratum" : [{ // Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
        "value" : { CodeableConcept }, // The stratum value, e.g. male
        "component" : [{ // Stratifier component values
          "code" : { CodeableConcept }, // R!  What stratifier component of the group
          "value" : { CodeableConcept } // R!  The stratum component value, e.g. male

        }],
        "

        "population" : [{ // Population results in this stratum
          "code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
          "count" : <integer>, // Size of the population
          "subjectResults" : { Reference(List) } // For subject-list reports, the subject results in this population
        }],
        "measureScore" : { Quantity } // What score this stratum achieved

      }]
    }]
  }],
  "

  "evaluatedResource" : [{ Reference(Any) }] // What data was used to calculate the measure score

}

Turtle Template 

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


[ a fhir:;

[ a fhir:MeasureReport;

  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:
  fhir:
  fhir:
  fhir:

  fhir:MeasureReport.identifier [ Identifier ], ... ; # 0..* Additional identifier for the MeasureReport
  fhir:MeasureReport.status [ code ]; # 1..1 complete | pending | error
  fhir:MeasureReport.type [ code ]; # 1..1 individual | subject-list | summary | data-collection
  fhir:MeasureReport.measure [ canonical(Measure) ]; # 1..1 What measure was calculated
  fhir:MeasureReport.subject [ Reference(Patient|Practitioner|PractitionerRole|Location|Device|RelatedPerson|Group) ]; # 0..1 What individual(s) the report is for

  fhir:MeasureReport.date [ dateTime ]; # 0..1 When the report was generated
  fhir:

  fhir:MeasureReport.reporter [ Reference(Practitioner|PractitionerRole|Location|Organization) ]; # 0..1 Who is reporting the data

  fhir:MeasureReport.period [ Period ]; # 1..1 What period the report covers
  fhir:MeasureReport.improvementNotation [ CodeableConcept ]; # 0..1 increase | decrease

  fhir:MeasureReport.group [ # 0..* Measure results for each group
    fhir:

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

    fhir:MeasureReport.group.population [ # 0..* The populations in the group
      fhir:
      fhir:

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

      fhir:MeasureReport.group.population.count [ integer ]; # 0..1 Size of the population
      fhir:

      fhir:MeasureReport.group.population.subjectResults [ Reference(List) ]; # 0..1 For subject-list reports, the subject results in this population

    ], ...;
    fhir:

    fhir:MeasureReport.group.measureScore [ Quantity ]; # 0..1 What score this group achieved

    fhir:MeasureReport.group.stratifier [ # 0..* Stratification results
      fhir:
      fhir:
        fhir:

      fhir:MeasureReport.group.stratifier.code [ CodeableConcept ], ... ; # 0..* What stratifier of the group
      fhir:MeasureReport.group.stratifier.stratum [ # 0..* Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
        fhir:MeasureReport.group.stratifier.stratum.value [ CodeableConcept ]; # 0..1 The stratum value, e.g. male
        fhir:MeasureReport.group.stratifier.stratum.component [ # 0..* Stratifier component values
          fhir:MeasureReport.group.stratifier.stratum.component.code [ CodeableConcept ]; # 1..1 What stratifier component of the group
          fhir:MeasureReport.group.stratifier.stratum.component.value [ CodeableConcept ]; # 1..1 The stratum component value, e.g. male
        ], ...;

        fhir:MeasureReport.group.stratifier.stratum.population [ # 0..* Population results in this stratum
          fhir:
          fhir:

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

          fhir:MeasureReport.group.stratifier.stratum.population.count [ integer ]; # 0..1 Size of the population
          fhir:

          fhir:MeasureReport.group.stratifier.stratum.population.subjectResults [ Reference(List) ]; # 0..1 For subject-list reports, the subject results in this population

        ], ...;
        fhir:

        fhir:MeasureReport.group.stratifier.stratum.measureScore [ Quantity ]; # 0..1 What score this stratum achieved

      ], ...;
    ], ...;
  ], ...;
  fhir:

  fhir:MeasureReport.evaluatedResource [ Reference(Any) ], ... ; # 0..* What data was used to calculate the measure score

]

Changes since DSTU2 R3

MeasureReport
MeasureReport.identifier
  • Max Cardinality changed from 1 to *
MeasureReport.status
  • Change value set from http://hl7.org/fhir/ValueSet/measure-report-status to http://hl7.org/fhir/ValueSet/measure-report-status|4.0.1
MeasureReport.type
  • Change value set from http://hl7.org/fhir/ValueSet/measure-report-type to http://hl7.org/fhir/ValueSet/measure-report-type|4.0.1
MeasureReport.measure
  • Type changed from Reference(Measure) to canonical(Measure)
MeasureReport.subject
  • Added Element
MeasureReport.reporter
  • Added Element
MeasureReport.improvementNotation
  • Added Element
MeasureReport.group.code
  • Added Element
MeasureReport.group.population.code
  • Change code system for extensibly bound codes from "http://hl7.org/fhir/measure-population" to "http://terminology.hl7.org/CodeSystem/measure-population"
MeasureReport.group.population.subjectResults
  • Added Element
MeasureReport.group.measureScore
  • Type changed from decimal to Quantity
MeasureReport.group.stratifier.code
  • Added Element
MeasureReport.group.stratifier.stratum.value
  • Min Cardinality changed from 1 to 0
  • Type changed from string to CodeableConcept
MeasureReport.group.stratifier.stratum.component
  • Added Element
MeasureReport.group.stratifier.stratum.component.code
  • Added Mandatory Element
MeasureReport.group.stratifier.stratum.component.value
  • Added Mandatory Element
MeasureReport.group.stratifier.stratum.population.code
  • Change code system for extensibly bound codes from "http://hl7.org/fhir/measure-population" to "http://terminology.hl7.org/CodeSystem/measure-population"
MeasureReport.group.stratifier.stratum.population.subjectResults
  • Added Element
MeasureReport.group.stratifier.stratum.measureScore
  • Type changed from decimal to Quantity
MeasureReport.evaluatedResource
  • Added Element
MeasureReport.patient
  • deleted
MeasureReport.reportingOrganization
  • deleted
MeasureReport.group.identifier
  • deleted
MeasureReport.group.population.identifier
  • deleted
MeasureReport.group.population.patients
  • deleted
MeasureReport.group.stratifier.identifier
  • deleted
MeasureReport.group.stratifier.stratum.population.identifier
  • deleted
MeasureReport.group.stratifier.stratum.population.patients
  • deleted
MeasureReport.evaluatedResources
  • deleted

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

This analysis is available as XML or JSON .

See R3 <--> R4 Conversion Maps (status = 3 tests that all execute ok. All tests pass round-trip testing and 3 r3 resources are invalid (0 errors). )

Structure

0..1 BackboneElement Measure results for each group BackboneElement The populations in Population results in this stratum Identifier Σ
Name Flags Card. Type Description & Constraints doco
. . MeasureReport I TU DomainResource Results of a measure evaluation
+ Rule: Measure Reports used for data collection SHALL NOT communicate group and score information
+ Rule: Stratifiers SHALL be either a single criteria or a set of criteria components
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier Additional identifier for the Report MeasureReport
. . . status ?! Σ 1..1 code complete | pending | error
MeasureReportStatus ( Required )
. . . type Σ I 1..1 code individual | patient-list subject-list | summary | data-collection
MeasureReportType ( Required )
. . . measure Σ 1..1 Reference canonical ( Measure ) What measure was evaluated calculated
. . patient . subject Σ 0..1 Reference ( Patient | Practitioner | PractitionerRole | Location | Device | RelatedPerson | Group ) What patient individual(s) the report is for
. . . date Σ 0..1 dateTime When the report was generated
. . reportingOrganization . reporter Σ 0..1 Reference ( Practitioner | PractitionerRole | Location | Organization ) Who is reporting the data
. . . period Σ 1..1 Period What period the report covers
. . group . improvementNotation ?! Σ 0..* 0..1 CodeableConcept increase | decrease
MeasureImprovementNotation ( Required )
. . identifier . group I 1..1 0..* Identifier BackboneElement What Measure results for each group of the measure
. . . population . code Σ 0..* 0..1 CodeableConcept Meaning of the group
. . . identifier . population Σ 0..1 0..* Identifier BackboneElement Population identifier as defined The populations in the measure group
. . . . . code Σ 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-score measure-observation
MeasurePopulationType ( Extensible )
. . . . . count 0..1 integer Size of the population
. . . . patients . subjectResults 0..1 Reference ( List ) For patient-list subject-list reports, the patients subject results in this population
. . . . measureScore Σ 0..1 decimal Quantity What score this group achieved
. . . . stratifier 0..* BackboneElement Stratification results
. . . . . identifier code 0..1 0..* Identifier CodeableConcept What stratifier of the group
. . . . . stratum 0..* BackboneElement Stratum results, one for each unique value value, or set of values, in the stratifier, or stratifier components
. . . . . . value 1..1 0..1 string CodeableConcept The stratum value, e.g. male
. . . . . population . component 0..* BackboneElement Stratifier component values
. . . . . . . identifier code Σ 1..1 0..1 CodeableConcept What stratifier component of the group
. . . . . . . value 1..1 CodeableConcept The stratum component value, e.g. male
...... population 0..* BackboneElement Population identifier as defined results in the measure this stratum
. . . . . . . code 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-score measure-observation
MeasurePopulationType ( Extensible )
. . . . . . . count 0..1 integer Size of the population
. . . . . . patients . subjectResults 0..1 Reference ( List ) For patient-list subject-list reports, the patients subject results in this population
. . . . . . measureScore Σ 0..1 decimal Quantity What score this stratum achieved
. . evaluatedResources . evaluatedResource 0..1 0..* Reference ( Bundle Any ) What data was evaluated used to produce calculate the measure score

doco Documentation for this format

UML Diagram ( Legend )

MeasureReport ( DomainResource ) A formal identifier that is used to identify this report MeasureReport when it is represented in other formats, formats or referenced in a specification, model, design or an instance identifier : Identifier [0..1] [0..*] The report MeasureReport status. No data will be available until the report MeasureReport status is complete (this element modifies the meaning of other elements) status : code [1..1] « The status of the measure report report. (Strength=Required) MeasureReportStatus ! » The type of measure report. This may be an individual report, which provides a single patient's the score for the measure; measure for an individual member of the population; a patient listing, subject-listing, which returns the list of patients members that meet the various criteria in the measure; or a summary report, which returns a population count for each of the criteria in the measure; or a data-collection, which enables the MeasureReport to be used to exchange the data-of-interest for a quality measure type : code [1..1] « The type of the measure report report. (Strength=Required) MeasureReportType ! » A reference to the Measure that was evaluated calculated to produce this report measure : Reference canonical [1..1] « Measure » Optional Patient if subject identifying the individual or individuals the report was requested is for a single patient patient subject : Reference [0..1] « Patient | Practitioner | PractitionerRole | Location | Device | RelatedPerson | Group » The date this measure report was generated date : dateTime [0..1] Reporting Organization The individual, location, or organization that is reporting the data reportingOrganization reporter : Reference [0..1] « Practitioner | PractitionerRole | Location | Organization » The reporting period for which the report was calculated period : Period [1..1] Whether improvement in the measure is noted by an increase or decrease in the measure score (this element modifies the meaning of other elements) improvementNotation : CodeableConcept [0..1] « Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue. (Strength=Required) MeasureImprovementNotation ! » A reference to a Bundle containing the Resources that were used in the evaluation calculation of this report measure evaluatedResources evaluatedResource : Reference [0..1] Bundle [0..*] « Any » Group The identifier meaning of the population group as defined in the measure definition identifier code : Identifier CodeableConcept [1..1] [0..1] The measure score for this population group, calculated as appropriate for the measure type and scoring method, and based on the contents of the populations defined in the group measureScore : decimal Quantity [0..1] Population The identifier of the population being reported, as defined by the population element of the measure identifier : Identifier [0..1] Population The type of the population code : CodeableConcept [0..1] « The type of population (e.g. initial, numerator, denominator, etc.) etc.). (Strength=Extensible) MeasurePopulationType + » The number of members of the population count : integer [0..1] This element refers to a List of patient subject level MeasureReport resources, one for each patient subject in this population patients subjectResults : Reference [0..1] « List » Stratifier The identifier meaning of this stratifier, as defined in the measure definition identifier code : Identifier CodeableConcept [0..1] [0..*] StratifierGroup The value for this stratum, expressed as a string. CodeableConcept. When defining stratifiers on complex values, the value must be rendered such that the value for each stratum within the stratifier is unique value : string CodeableConcept [1..1] [0..1] The measure score for this stratum, calculated as appropriate for the measure type and scoring method, and based on only the members of this stratum measureScore : decimal Quantity [0..1] StratifierGroupPopulation Component The identifier of the population being reported, as defined by the population element of code for the measure stratum component value identifier code : Identifier CodeableConcept [0..1] [1..1] The stratum component value value : CodeableConcept [1..1] StratifierGroupPopulation The type of the population code : CodeableConcept [0..1] « The type of population (e.g. initial, numerator, denominator, etc.) etc.). (Strength=Extensible) MeasurePopulationType + » The number of members of the population in this stratum count : integer [0..1] This element refers to a List of patient subject level MeasureReport resources, one for each patient subject in this population in this stratum patients subjectResults : Reference [0..1] « List » The populations that make up the population group, one for each type of population appropriate for the measure population [0..*] A stratifier component value component [0..*] The populations that make up the stratum, one for each type of population appropriate to the measure population [0..*] This element contains the results for a single stratum within the stratifier. For example, when stratifying on administrative gender, there will be four strata, one for each possible gender value stratum [0..*] When a measure includes multiple stratifiers, there will be a stratifier group for each stratifier defined by the measure stratifier [0..*] The results of the calculation, one for each population group in the measure group [0..*]

XML Template 

<

<MeasureReport xmlns="http://hl7.org/fhir"> doco

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <</identifier>
 <
 <
 <</measure>
 <</patient>
 <
 <</reportingOrganization>

 <identifier><!-- 0..* Identifier Additional identifier for the MeasureReport --></identifier>
 <status value="[code]"/><!-- 1..1 complete | pending | error -->
 <type value="[code]"/><!-- ?? 1..1 individual | subject-list | summary | data-collection -->
 <measure><!-- 1..1 canonical(Measure) What measure was calculated --></measure>
 <subject><!-- 0..1 Reference(Patient|Practitioner|PractitionerRole|Location|
   Device|RelatedPerson|Group) What individual(s) the report is for --></subject>

 <date value="[dateTime]"/><!-- 0..1 When the report was generated -->
 <reporter><!-- 0..1 Reference(Practitioner|PractitionerRole|Location|
   Organization) Who is reporting the data --></reporter>
 <period><!-- 1..1 Period What period the report covers --></period>
 <
  <</identifier>

 <improvementNotation><!-- 0..1 CodeableConcept increase | decrease --></improvementNotation>
 <group>  <!-- ?? 0..* Measure results for each group -->
  <code><!-- 0..1 CodeableConcept Meaning of the group --></code>

  <population>  <!-- 0..* The populations in the group -->
   <</identifier>
   <</code>
   <
   <</patients>

   <code><!-- 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation --></code>
   <count value="[integer]"/><!-- 0..1 Size of the population -->
   <subjectResults><!-- 0..1 Reference(List) For subject-list reports, the subject results in this population --></subjectResults>

  </population>
  <

  <measureScore><!-- 0..1 Quantity What score this group achieved --></measureScore>

  <stratifier>  <!-- 0..* Stratification results -->
   <</identifier>
   <
    <

   <code><!-- 0..* CodeableConcept What stratifier of the group --></code>
   <stratum>  <!-- 0..* Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components -->
    <value><!-- 0..1 CodeableConcept The stratum value, e.g. male --></value>
    <component>  <!-- 0..* Stratifier component values -->
     <code><!-- 1..1 CodeableConcept What stratifier component of the group --></code>
     <value><!-- 1..1 CodeableConcept The stratum component value, e.g. male --></value>
    </component>

    <population>  <!-- 0..* Population results in this stratum -->
     <</identifier>
     <</code>
     <
     <</patients>

     <code><!-- 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation --></code>
     <count value="[integer]"/><!-- 0..1 Size of the population -->
     <subjectResults><!-- 0..1 Reference(List) For subject-list reports, the subject results in this population --></subjectResults>

    </population>
    <

    <measureScore><!-- 0..1 Quantity What score this stratum achieved --></measureScore>

   </stratum>
  </stratifier>
 </group>
 <</evaluatedResources>

 <evaluatedResource><!-- 0..* Reference(Any) What data was used to calculate the measure score --></evaluatedResource>

</MeasureReport>

JSON Template 

{doco
  "resourceType" : "",

  "resourceType" : "MeasureReport",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "
  "
  "
  "
  "
  "
  "
  "
  "
    "
    "
      "
      "
      "
      "

  "identifier" : [{ Identifier }], // Additional identifier for the MeasureReport
  "status" : "<code>", // R!  complete | pending | error
  "type" : "<code>", // C? R!  individual | subject-list | summary | data-collection
  "measure" : { canonical(Measure) }, // R!  What measure was calculated
  "subject" : { Reference(Patient|Practitioner|PractitionerRole|Location|
   Device|RelatedPerson|Group) }, // What individual(s) the report is for

  "date" : "<dateTime>", // When the report was generated
  "reporter" : { Reference(Practitioner|PractitionerRole|Location|
   Organization) }, // Who is reporting the data

  "period" : { Period }, // R!  What period the report covers
  "improvementNotation" : { CodeableConcept }, // increase | decrease
  "group" : [{ // C? Measure results for each group
    "code" : { CodeableConcept }, // Meaning of the group
    "population" : [{ // The populations in the group
      "code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      "count" : <integer>, // Size of the population
      "subjectResults" : { Reference(List) } // For subject-list reports, the subject results in this population

    }],
    "
    "
      "
      "
        "
        "
          "
          "
          "
          "

    "measureScore" : { Quantity }, // What score this group achieved
    "stratifier" : [{ // Stratification results
      "code" : [{ CodeableConcept }], // What stratifier of the group
      "stratum" : [{ // Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
        "value" : { CodeableConcept }, // The stratum value, e.g. male
        "component" : [{ // Stratifier component values
          "code" : { CodeableConcept }, // R!  What stratifier component of the group
          "value" : { CodeableConcept } // R!  The stratum component value, e.g. male

        }],
        "

        "population" : [{ // Population results in this stratum
          "code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
          "count" : <integer>, // Size of the population
          "subjectResults" : { Reference(List) } // For subject-list reports, the subject results in this population
        }],
        "measureScore" : { Quantity } // What score this stratum achieved

      }]
    }]
  }],
  "

  "evaluatedResource" : [{ Reference(Any) }] // What data was used to calculate the measure score

}

Turtle Template 

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


[ a fhir:;

[ a fhir:MeasureReport;

  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:
  fhir:
  fhir:
  fhir:

  fhir:MeasureReport.identifier [ Identifier ], ... ; # 0..* Additional identifier for the MeasureReport
  fhir:MeasureReport.status [ code ]; # 1..1 complete | pending | error
  fhir:MeasureReport.type [ code ]; # 1..1 individual | subject-list | summary | data-collection
  fhir:MeasureReport.measure [ canonical(Measure) ]; # 1..1 What measure was calculated
  fhir:MeasureReport.subject [ Reference(Patient|Practitioner|PractitionerRole|Location|Device|RelatedPerson|Group) ]; # 0..1 What individual(s) the report is for

  fhir:MeasureReport.date [ dateTime ]; # 0..1 When the report was generated
  fhir:

  fhir:MeasureReport.reporter [ Reference(Practitioner|PractitionerRole|Location|Organization) ]; # 0..1 Who is reporting the data

  fhir:MeasureReport.period [ Period ]; # 1..1 What period the report covers
  fhir:MeasureReport.improvementNotation [ CodeableConcept ]; # 0..1 increase | decrease

  fhir:MeasureReport.group [ # 0..* Measure results for each group
    fhir:

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

    fhir:MeasureReport.group.population [ # 0..* The populations in the group
      fhir:
      fhir:

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

      fhir:MeasureReport.group.population.count [ integer ]; # 0..1 Size of the population
      fhir:

      fhir:MeasureReport.group.population.subjectResults [ Reference(List) ]; # 0..1 For subject-list reports, the subject results in this population

    ], ...;
    fhir:

    fhir:MeasureReport.group.measureScore [ Quantity ]; # 0..1 What score this group achieved

    fhir:MeasureReport.group.stratifier [ # 0..* Stratification results
      fhir:
      fhir:
        fhir:

      fhir:MeasureReport.group.stratifier.code [ CodeableConcept ], ... ; # 0..* What stratifier of the group
      fhir:MeasureReport.group.stratifier.stratum [ # 0..* Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
        fhir:MeasureReport.group.stratifier.stratum.value [ CodeableConcept ]; # 0..1 The stratum value, e.g. male
        fhir:MeasureReport.group.stratifier.stratum.component [ # 0..* Stratifier component values
          fhir:MeasureReport.group.stratifier.stratum.component.code [ CodeableConcept ]; # 1..1 What stratifier component of the group
          fhir:MeasureReport.group.stratifier.stratum.component.value [ CodeableConcept ]; # 1..1 The stratum component value, e.g. male
        ], ...;

        fhir:MeasureReport.group.stratifier.stratum.population [ # 0..* Population results in this stratum
          fhir:
          fhir:

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

          fhir:MeasureReport.group.stratifier.stratum.population.count [ integer ]; # 0..1 Size of the population
          fhir:

          fhir:MeasureReport.group.stratifier.stratum.population.subjectResults [ Reference(List) ]; # 0..1 For subject-list reports, the subject results in this population

        ], ...;
        fhir:

        fhir:MeasureReport.group.stratifier.stratum.measureScore [ Quantity ]; # 0..1 What score this stratum achieved

      ], ...;
    ], ...;
  ], ...;
  fhir:

  fhir:MeasureReport.evaluatedResource [ Reference(Any) ], ... ; # 0..* What data was used to calculate the measure score

]

Changes since DSTU2 Release 3

MeasureReport
MeasureReport.identifier
  • Max Cardinality changed from 1 to *
MeasureReport.status
  • Change value set from http://hl7.org/fhir/ValueSet/measure-report-status to http://hl7.org/fhir/ValueSet/measure-report-status|4.0.1
MeasureReport.type
  • Change value set from http://hl7.org/fhir/ValueSet/measure-report-type to http://hl7.org/fhir/ValueSet/measure-report-type|4.0.1
MeasureReport.measure
  • Type changed from Reference(Measure) to canonical(Measure)
MeasureReport.subject
  • Added Element
MeasureReport.reporter
  • Added Element
MeasureReport.improvementNotation
  • Added Element
MeasureReport.group.code
  • Added Element
MeasureReport.group.population.code
  • Change code system for extensibly bound codes from "http://hl7.org/fhir/measure-population" to "http://terminology.hl7.org/CodeSystem/measure-population"
MeasureReport.group.population.subjectResults
  • Added Element
MeasureReport.group.measureScore
  • Type changed from decimal to Quantity
MeasureReport.group.stratifier.code
  • Added Element
MeasureReport.group.stratifier.stratum.value
  • Min Cardinality changed from 1 to 0
  • Type changed from string to CodeableConcept
MeasureReport.group.stratifier.stratum.component
  • Added Element
MeasureReport.group.stratifier.stratum.component.code
  • Added Mandatory Element
MeasureReport.group.stratifier.stratum.component.value
  • Added Mandatory Element
MeasureReport.group.stratifier.stratum.population.code
  • Change code system for extensibly bound codes from "http://hl7.org/fhir/measure-population" to "http://terminology.hl7.org/CodeSystem/measure-population"
MeasureReport.group.stratifier.stratum.population.subjectResults
  • Added Element
MeasureReport.group.stratifier.stratum.measureScore
  • Type changed from decimal to Quantity
MeasureReport.evaluatedResource
  • Added Element
MeasureReport.patient
  • deleted
MeasureReport.reportingOrganization
  • deleted
MeasureReport.group.identifier
  • deleted
MeasureReport.group.population.identifier
  • deleted
MeasureReport.group.population.patients
  • deleted
MeasureReport.group.stratifier.identifier
  • deleted
MeasureReport.group.stratifier.stratum.population.identifier
  • deleted
MeasureReport.group.stratifier.stratum.population.patients
  • deleted
MeasureReport.evaluatedResources
  • deleted

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

This analysis is available as XML or JSON .

See R3 <--> R4 Conversion Maps (status = 3 tests that all execute ok. All tests pass round-trip testing and 3 r3 resources are invalid (0 errors). )

 

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

14.6.3.1 14.15.3.1 Terminology Bindings

Path Definition Type Reference
MeasureReport.status The status of the measure report report. Required MeasureReportStatus
MeasureReport.type The type of the measure report report. Required MeasureReportType
MeasureReport.improvementNotation Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue. Required MeasureImprovementNotation
MeasureReport.group.population.code
MeasureReport.group.stratifier.stratum.population.code 		The type of population (e.g. initial, numerator, denominator, etc.) etc.). Extensible MeasurePopulationType

14.15.3.2 Constraints

id Level Location Description Expression
mrp-1 Rule (base) Measure Reports used for data collection SHALL NOT communicate group and score information (type != 'data-collection') or group.exists().not()
mrp-2 Rule (base) Stratifiers SHALL be either a single criteria or a set of criteria components group.stratifier.stratum.all(value.exists() xor component.exists())

14.6.4 14.15.4 MeasureReport Search

Although the MeasureReport resource does define search parameters, it is up to the individual measure evaluation service whether or not historical records of measure evaluation requests are preserved. A service may might not support searching on MeasureReports at all, or it may support searching only for a pre-defined expiration period. The search parameters are defined to provide consumers with a consistent interface to searching if it is available for a specific service implementation. In any case, services should detail the support they do provide using a CapabilityStatement.

14.6.5 14.15.5 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
date date The date of the measure report MeasureReport.date
evaluated-resource reference An evaluated resource referenced by the measure report MeasureReport.evaluatedResource
(Any)
identifier token External identifier of the measure report to be returned MeasureReport.identifier
measure reference The measure to return measure report results for MeasureReport.measure
( Measure )
patient reference The identity of a patient to search for individual measure report results for MeasureReport.patient MeasureReport.subject.where(resolve() is Patient)
( Patient )
period date The period of the measure report MeasureReport.period
reporter reference The reporter to return measure report results for MeasureReport.reporter
( Practitioner , Organization , PractitionerRole , Location )
status token The status of the measure report MeasureReport.status
subject reference The identity of a subject to search for individual measure report results for MeasureReport.subject
( Practitioner , Group , Device , Patient , PractitionerRole , RelatedPerson , Location )