Release
4B
5
Clinical
Reasoning
This
page
is
part
of
the
FHIR
Specification
(v4.3.0:
R4B
(v5.0.0:
R5
-
STU
).
The
This
is
the
current
published
version
which
supercedes
in
it's
permanent
home
(it
will
always
be
available
at
this
version
is
5.0.0
.
URL).
For
a
full
list
of
available
versions,
see
the
Directory
of
published
versions
.
Page
versions:
R5
R4B
R5
R4B
R4
| Clinical Quality Information Work Group | Maturity Level : 0 | Trial Use | Use Context : Any |
Shareable
Measure
ShareableMeasure
<?xml version="1.0" encoding="UTF-8"?>Enforces the minimum information set for the measure metadata required by HL7 and other organizations that share and publish measures<StructureDefinition xmlns="http://hl7.org/fhir"> <id value="shareablemeasure"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"> <valueInteger value="3"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="cqi"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"> <valueCode value="trial-use"/> </extension> <url value="http://hl7.org/fhir/StructureDefinition/shareablemeasure"/> <identifier> <system value="urn:ietf:rfc:3986"/> <value value="urn:oid:2.16.840.1.113883.4.642.5.1376"/> </identifier> <version value="5.0.0"/> <name value="ShareableMeasure"/> <title value="Shareable Measure"/> <status value="draft"/> <experimental value="false"/> <date value="2020-12-28T16:55:11+11:00"/> <publisher value="HL7"/> <description value="Enforces the minimum information set for the measure metadata required by HL7 and other organizations that share and publish measures"/> <fhirVersion value="5.0.0"/> <mapping> <identity value="rim"/> <uri value="http://hl7.org/v3"/> <name value="RIM Mapping"/> </mapping> <mapping> <identity value="workflow"/> <uri value="http://hl7.org/fhir/workflow"/> <name value="Workflow Pattern"/> </mapping> <mapping> <identity value="w5"/> <uri value="http://hl7.org/fhir/fivews"/> <name value="FiveWs Pattern Mapping"/> </mapping> <mapping> <identity value="objimpl"/> <uri value="http://hl7.org/fhir/object-implementation"/> <name value="Object Implementation Information"/> </mapping> <kind value="resource"/> <abstract value="false"/> <type value="Measure"/> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Measure"/> <derivation value="constraint"/> <snapshot> <element id="Measure"> <path value="Measure"/> <short value="A quality measure definition"/> <definition value="The Measure resource provides the definition of a quality measure."/> <min value="1"/> <max value="1"/> <base> <path value="Measure"/> <min value="0"/> <max value="*"/> </base> <constraint> <key value="cnl-0"/> <severity value="warning"/> <human value="Name should be usable as an identifier for the module by machine processing applicationssuch as code generation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descenda nts().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty() not(exists(for $contained in f:contained return $contained[not(exists(parent::*/descendant::f:refere nce/@value=concat('#', $contained/*/f:id/@value)) or exists(descendant::f:reference[@value='#']))])) If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time. The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation.such as code generation"/> <expression value="name.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$')"/> <source value="http://hl7.org/fhir/StructureDefinition/Measure"/> </constraint> <constraint> <key value="mea-1"/> <severity value="error"/> <human value="Stratifier SHALL be either a single criteria or a set of criteria components"/> <expression value="group.stratifier.all((code | description | criteria).exists() xor component.exists())"/> <source value="http://hl7.org/fhir/StructureDefinition/Measure"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="w5"/> <map value="conformance.behavior,clinical.general"/> </mapping> <mapping> <identity value="workflow"/> <map value="Definition"/> </mapping> <mapping> <identity value="rim"/> <map value="Observation[classCode=OBS, moodCode=DEFN]"/> </mapping> </element> <element id="Measure.id"> <path value="Measure.id"/> <short value="Logical id of this artifact"/> <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/> <comment value="Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="Measure.meta"> <path value="Measure.meta"/> <short value="Metadata about the resource"/> <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.Changes to the content might not always be associated with version changes to the resource. A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.Changes to the content might not always be associated with version changes to the resource."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.meta"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Meta"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="Measure.implicitRules"> <path value="Measure.implicitRules"/> <short value="A set of rules under which this content was created"/> <definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc."/> <comment value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.implicitRules"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additionalknowledge about the resource that modifies it's meaning or interpretation Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefi nition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorizat ion or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic) not(f:Citation|f:Evidence|f:EvidenceReport|f:EvidenceVariable|f:MedicinalProductDefinition|f:Package dProductDefinition|f:AdministrableProductDefinition|f:Ingredient|f:ClinicalUseDefinition|f:RegulatedA uthorization|f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic) or not(parent::f:Citatio n|parent::f:Evidence|parent::f:EvidenceReport|parent::f:EvidenceVariable|parent::f:MedicinalProductDe finition|parent::f:PackagedProductDefinition|parent::f:AdministrableProductDefinition|parent::f:Ingre dient|parent::f:ClinicalUseDefinition|parent::f:RegulatedAuthorization|parent::f:SubstanceDefinition| f:SubscriptionStatus|f:SubscriptionTopic) May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.knowledge about the resource that modifies its meaning or interpretation"/> <isSummary value="true"/> </element> <element id="Measure.language"> <path value="Measure.language"/> <short value="Language of the resource content"/> <definition value="The base language in which the resource is written."/> <comment value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.language"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Language"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="required"/> <description value="IETF language tag for a human language"/> <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|5.0.0"/> <additional> <purpose value="starter"/> <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> </additional> </binding> </element> <element id="Measure.text"> <path value="Measure.text"/> <short value="Text summary of the resource, for human interpretation"/> <definition value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/> <comment value="Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later."/> <alias value="narrative"/> <alias value="html"/> <alias value="xhtml"/> <alias value="display"/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Narrative"/> </type> <condition value="dom-6"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Act.text?"/> </mapping> </element> <element id="Measure.contained"> <path value="Measure.contained"/> <short value="Contained, inline Resources"/> <definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning."/> <comment value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels."/> <alias value="inline resources"/> <alias value="anonymous resources"/> <alias value="contained resources"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.contained"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Resource"/> </type> <condition value="dom-2"/> <condition value="dom-4"/> <condition value="dom-3"/> <condition value="dom-5"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Measure.extension"> <path value="Measure.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> <short value="Extension"/> <definition value="An Extension"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Measure.extension:knowledgeCapability"> <path value="Measure.extension"/> <sliceName value="knowledgeCapability"/> <short value="shareable | computable | publishable | executable"/> <definition value="Defines a knowledge capability afforded by this knowledge artifact."/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> </element> <element id="Measure.extension:knowledgeRepresentationLevel"> <path value="Measure.extension"/> <sliceName value="knowledgeRepresentationLevel"/> <short value="narrative | semi-structured | structured | executable"/> <definition value="Defines a knowledge representation level provided by this knowledge artifact."/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeRepresentationLevel"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> </element> <element id="Measure.extension:artifactComment"> <path value="Measure.extension"/> <sliceName value="artifactComment"/> <short value="Additional documentation, review, or usage guidance"/> <definition value="A comment containing additional documentation, a review comment, usage guidance, or other relevant information from a particular user."/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/StructureDefinition/cqf-artifactComment"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> </element> <element id="Measure.modifierExtension"> <path value="Measure.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definitionof the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.ht ml#modifierExtension). Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them An absolute URI that is used to identify this measure when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this measure is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the measure is stored on different servers. Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version. The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in [Technical and Business Versions](resource.html#versions). In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the [meta.source](resource.html#meta) element to indicate where the current master source of the resource can be found. A formal identifier that is used to identify this measure when it is represented in other formats, or referenced in a specification, model, design or an instance.of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Measure.url"> <path value="Measure.url"/> <short value="Canonical identifier for this measure, represented as a URI (globally unique)"/> <definition value="An absolute URI that is used to identify this measure when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which an authoritative instance of this measure is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the measure is stored on different servers."/> <comment value="Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version. The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in [Technical and Business Versions](resource.html#versions). In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the [meta.source](resource.html#meta) element to indicate where the current master source of the resource can be found."/> <requirements value="Allows the measure to be referenced by a single globally unique identifier."/> <min value="1"/> <max value="1"/> <base> <path value="Measure.url"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <constraint> <key value="cnl-1"/> <severity value="warning"/> <human value="URL should not contain | or # - these characters make processing canonical references problematic"/> <expression value="exists() implies matches('^[^|# ]+$')"/> <source value="http://hl7.org/fhir/StructureDefinition/Measure"/> </constraint> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Definition.url"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.identifier"/> </mapping> <mapping> <identity value="rim"/> <map value=".identifier[scope=BUSN;reliability=ISS]"/> </mapping> </element> <element id="Measure.identifier"> <path value="Measure.identifier"/> <short value="Additional identifier for the measure"/> <definition value="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."/> <comment value="Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier)data type, and can then identify this measure outside of FHIR, where it is not possible to use the logical URI.data type, and can then identify this measure outside of FHIR, where it is not possible to use the logical URI."/> <requirements value="Allows externally provided and/or usable business identifiers to be easily associatedwith the module. The identifier that is used to identify this version of the measure when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the measure author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifacts. There may be different measure instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the measure with the format [url]|[version]. 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.with the module."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.identifier"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Identifier"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Definition.identifier"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.identifier"/> </mapping> <mapping> <identity value="rim"/> <map value=".identifier"/> </mapping> <mapping> <identity value="objimpl"/> <map value="no-gen-base"/> </mapping> </element> <element id="Measure.version"> <path value="Measure.version"/> <short value="Business version of the measure"/> <definition value="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."/> <comment value="There may be different measure instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the measure with the format [url]|[version]. The version SHOULD NOT contain a '#' - see [Business Version](resource.html#bv-format)."/> <min value="1"/> <max value="1"/> <base> <path value="Measure.version"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Definition.version"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.version"/> </mapping> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> <mapping> <identity value="objimpl"/> <map value="no-gen-base"/> </mapping> </element> <element id="Measure.versionAlgorithm[x]"> <path value="Measure.versionAlgorithm[x]"/> <short value="How to compare versions"/> <definition value="Indicates the mechanism used to compare versions to determine which is more current."/> <comment value="If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.versionAlgorithm[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <type> <code value="Coding"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <strength value="extensible"/> <valueSet value="http://hl7.org/fhir/ValueSet/version-algorithm"/> </binding> <mapping> <identity value="workflow"/> <map value="Definition.versionAlgorithm"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.version"/> </mapping> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> <mapping> <identity value="objimpl"/> <map value="no-gen-base"/> </mapping> </element> <element id="Measure.name"> <path value="Measure.name"/> <short value="Name for this measure (computer friendly)"/> <definition value="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."/> <comment value="The name is not expected to be globally unique. The name should be a simple alphanumerictype name to ensure that it is machine-processing friendly.type name to ensure that it is machine-processing friendly."/> <requirements value="Support human navigation and code generation."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.name"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <condition value="cnl-0"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Definition.name"/> </mapping> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Measure.title"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Measure.title"/> <short value="Name for this measure (human friendly)"/> <definition value="A short, descriptive, user-friendly title for the measure."/> <comment value="This name does not need to be machine-processing friendly and may contain punctuation,white-space, etc. An explanatory or alternate title for the measure giving additional information about its content. This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration A Boolean value to indicate that this measure is authored for testing purposes (or education/evaluat ion/marketing) and is not intended to be used for genuine usage. Enables experimental content to be developed following the same lifecycle that would be used for a production-level measure. The intended subjects for the measure. If this element is not provided, a Patient subject is assumed, but the subject of the measure can be anything. The subject of the measure is critical in interpreting the criteria definitions, as the logic in the measures is evaluated with respect to a particular subject. This corresponds roughly to the notion of a Compartment in that it limits what content is available based on its relationship to the subject. In CQL, this corresponds to the context declaration.white-space, etc."/> <min value="1"/> <max value="1"/> <base> <path value="Measure.title"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Definition.title"/> </mapping> <mapping> <identity value="rim"/> <map value=".title"/> </mapping> </element> <element id="Measure.subtitle"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Measure.subtitle"/> <short value="Subordinate title of the measure"/> <definition value="An explanatory or alternate title for the measure giving additional information about its content."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.subtitle"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.status"> <path value="Measure.status"/> <short value="draft | active | retired | unknown"/> <definition value="The status of this measure. Enables tracking the life-cycle of the content."/> <comment value="Allows filtering of measures that are appropriate for use versus not. See guidance around (not) making local changes to elements [here](canonicalresource.html#loca lization)."/> <min value="1"/> <max value="1"/> <base> <path value="Measure.status"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="PublicationStatus"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="required"/> <description value="The lifecycle status of an artifact."/> <valueSet value="http://hl7.org/fhir/ValueSet/publication-status|5.0.0"/> </binding> <mapping> <identity value="workflow"/> <map value="Definition.status"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.status"/> </mapping> <mapping> <identity value="rim"/> <map value=".status"/> </mapping> </element> <element id="Measure.experimental"> <path value="Measure.experimental"/> <short value="For testing purposes, not real usage"/> <definition value="A Boolean value to indicate that this measure is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage."/> <comment value="Allows filtering of measures that are appropriate for use versus not."/> <requirements value="Enables experimental content to be developed following the same lifecycle that would be used for a production-level measure."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.experimental"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <meaningWhenMissing value="If absent, this resource is treated as though it is not experimental."/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Definition.experimental"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.class"/> </mapping> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.subject[x]"> <path value="Measure.subject[x]"/> <short value="E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device"/> <definition value="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."/> <comment value="The subject of the measure is critical in interpreting the criteria definitions, as the logic in the measures is evaluated with respect to a particular subject. This corresponds roughly to the notion of a Compartment in that it limits what content is available based on its relationship to the subject. In CQL, this corresponds to the context declaration."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.subject[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> </type> <meaningWhenMissing value="Patient"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="SubjectType"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="extensible"/> <description value="The possible types of subjects for a measure (E.g. Patient, Practitioner, Organization,Location, etc.). The date (and optionally time) when the measure was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the measure changes. Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the measure. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource. Usually an organization but may be an individual. The publisher (or steward) of the measure is the organization or individual primarily responsible for the maintenance and upkeep of the measure. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the measure. This item SHOULD be populated unless the information is available from context. Helps establish the "authority/credibility" of the measure. May also allow for contact. This description can be used to capture details such as why the measure was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the measure as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the measure is presumed to be the predominant language in the place the measure was created). The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate measure instances. When multiple useContexts are specified, there is no expectation that all or any of the contexts apply. It may be possible for the measure to be used in jurisdictions other than those for which it was originally designed or intended.Location, etc.)."/> <valueSet value="http://hl7.org/fhir/ValueSet/participant-resource-types"/> </binding> <mapping> <identity value="rim"/> <map value="N/A (to add?) { only applies for subject Patient? }"/> </mapping> </element> <element id="Measure.basis"> <path value="Measure.basis"/> <short value="Population basis"/> <definition value="The population basis specifies the type of elements in the population. For a subject-based measure, this is boolean (because the subject and the population basis are the same, and the population criteria define yes/no values for each individual in the population). For measures that have a population basis that is different than the subject, this element specifies the type of the population basis. For example, an encounter-based measure has a subject of Patient and a population basis of Encounter, and the population criteria all return lists of Encounters."/> <comment value="For a subject-based measure, the population basis is simply boolean; all the criteria are expressed as true/false conditions that determine membership of an individual case in the population. For non-subject-based measures, the population basis can be any resource type, and the criteria are queries that return the subject's contribution to the population as a list of that resource type. For example, for a procedure-based measure, the population criteria would return lists of procedures that should be included in each population."/> <requirements value="Allows non-subject-based measures to be specified. Note that because the binding is to all fhir types, it is possible to specify abstract types such as Resource or DomainResource as the basis for a measure. Authoring environments may wish to constrain this further, depending on content needs."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.basis"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <meaningWhenMissing value="boolean"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BasisType"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="required"/> <valueSet value="http://hl7.org/fhir/ValueSet/fhir-types|5.0.0"/> </binding> <mapping> <identity value="rim"/> <map value="N/A (to add?) { only applies for subject Patient? }"/> </mapping> </element> <element id="Measure.date"> <path value="Measure.date"/> <short value="Date last changed"/> <definition value="The date (and optionally time) when the measure was last significantly changed. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the measure changes."/> <comment value="The date is often not tracked until the resource is published, but may be present on draft content. Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the measure. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource. See guidance around (not) making local changes to elements [here](canonicalresource.html#loca lization)."/> <alias value="Revision Date"/> <min value="0"/> <max value="1"/> <base> <path value="Measure.date"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Definition.date"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.recorded"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=AUT].time"/> </mapping> </element> <element id="Measure.publisher"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Measure.publisher"/> <short value="Name of the publisher/steward (organization or individual)"/> <definition value="The name of the organization or individual responsible for the release and ongoing maintenance of the measure."/> <comment value="Usually an organization but may be an individual. The publisher (or steward) of the measure is the organization or individual primarily responsible for the maintenance and upkeep of the measure. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the measure. This item SHOULD be populated unless the information is available from context."/> <requirements value="Helps establish the "authority/credibility" of the measure. May also allow for contact."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.publisher"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Definition.publisher"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.witness"/> </mapping> <mapping> <identity value="rim"/> <map value="participation[typeCode=AUT].role"/> </mapping> </element> <element id="Measure.contact"> <path value="Measure.contact"/> <short value="Contact details for the publisher"/> <definition value="Contact details to assist a user in finding and communicating with the publisher."/> <comment value="May be a web site, an email address, a telephone number, etc. See guidance around (not) making local changes to elements [here](canonicalresource.html#loca lization)."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.contact"/> <min value="0"/> <max value="*"/> </base> <type> <code value="ContactDetail"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Definition.contact"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=CALLBCK].role"/> </mapping> </element> <element id="Measure.description"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Measure.description"/> <short value="Natural language description of the measure"/> <definition value="A free text natural language description of the measure from a consumer's perspective."/> <comment value="This description can be used to capture details such as comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the measure as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the measure is presumed to be the predominant language in the place the measure was created)."/> <min value="1"/> <max value="1"/> <base> <path value="Measure.description"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Definition.description"/> </mapping> <mapping> <identity value="rim"/> <map value=".text"/> </mapping> </element> <element id="Measure.useContext"> <path value="Measure.useContext"/> <short value="The context that the content is intended to support"/> <definition value="The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate measure instances."/> <comment value="When multiple useContexts are specified, there is no expectation that all or any of the contexts apply."/> <requirements value="Assist in searching for appropriate content."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.useContext"/> <min value="0"/> <max value="*"/> </base> <type> <code value="UsageContext"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Definition.useContext"/> </mapping> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.jurisdiction"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"> <valueCode value="deprecated"/> </extension> <path value="Measure.jurisdiction"/> <short value="Intended jurisdiction for measure (if applicable)"/> <definition value="A legal or geographic region in which the measure is intended to be used."/> <comment value="It may be possible for the measure to be used in jurisdictions other than those for which it was originally designed or intended. DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to using the new 'jurisdiction' code in the useContext element. (I.e. useContext.code indicating http://terminology.hl7.org/CodeSystem/usage-context-type#jurisdiction and useContext.valueCodeableConcept indicating the jurisdiction.)"/> <min value="0"/> <max value="*"/> <base> <path value="Measure.jurisdiction"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Jurisdiction"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="extensible"/> <description value="Countries and regions within which this artifact is targeted for use."/> <valueSet value="http://hl7.org/fhir/ValueSet/jurisdiction"/> </binding> <mapping> <identity value="workflow"/> <map value="Definition.jurisdiction"/> </mapping> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.purpose"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Measure.purpose"/> <short value="Why this measure is defined"/> <definition value="Explanation of why this measure is needed and why it has been designed as it has."/> <comment value="This element does not describe the usage of the measure. Instead, it provides traceabilityof ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this measure.of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this measure."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.purpose"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Definition.purpose"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.why[x]"/> </mapping> <mapping> <identity value="rim"/> <map value=".reasonCode.text"/> </mapping> <mapping> <identity value="objimpl"/> <map value="no-gen-base"/> </mapping> </element> <element id="Measure.usage"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Measure.usage"/> <short value="Describes the clinical usage of the measure"/> <definition value="A detailed description, from a clinical perspective, of how the measure is used."/> <comment value="This metadata element was typically referred to as Guidance in HQMF"/> <requirements value="Measure developers must be able to provide additional guidance for implementers to understand the intent with greater specificity than that provided in the population criteria of the measure. This element provides detailed guidance, where the usage element provides a summary of the guidance."/> <alias value="guidance"/> <min value="0"/> <max value="1"/> <base> <path value="Measure.usage"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.copyright"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Measure.copyright"/> <short value="Use and/or publishing restrictions"/> <definition value="A copyright statement relating to the measure and/or its contents. Copyright statementsare generally legal restrictions on the use and publishing of the measure. Consumers must be able to determine any legal restrictions on the use of the measure and/or its content. The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.are generally legal restrictions on the use and publishing of the measure."/> <comment value="The short copyright declaration (e.g. (c) '2015+ xyz organization' should be sent in the copyrightLabel element."/> <requirements value="Consumers must be able to determine any legal restrictions on the use of the measure and/or its content."/> <alias value="License"/> <alias value="Restrictions"/> <min value="0"/> <max value="1"/> <base> <path value="Measure.copyright"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Definition.copyright"/> </mapping> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> <mapping> <identity value="objimpl"/> <map value="no-gen-base"/> </mapping> </element> <element id="Measure.copyrightLabel"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Measure.copyrightLabel"/> <short value="Copyright holder and year(s)"/> <definition value="A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. (e.g. 'All rights reserved', 'Some rights reserved')."/> <comment value="The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element."/> <requirements value="Defines the content expected to be rendered in all representations of the artifact."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.copyrightLabel"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Definition.copyrightLabel"/> </mapping> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> <mapping> <identity value="objimpl"/> <map value="no-gen-base"/> </mapping> </element> <element id="Measure.approvalDate"> <path value="Measure.approvalDate"/> <short value="When the measure was approved by publisher"/> <definition value="The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage."/> <comment value="The 'date' element may be more recent than the approval date because of minor changesor editorial corrections. .outboundRelationship[typeCode=SUBJ].act[classCode=CACT;moodCode=EVN;code="approval"].effe ctiveTimeor editorial corrections. See guidance around (not) making local changes to elements [here](canonicalresource.html#loca lization)."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.approvalDate"/> <min value="0"/> <max value="1"/> </base> <type> <code value="date"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Definition.approvalDate"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=SUBJ].act[classCode=CACT;moodCode=EVN;code="approval" ;].effectiveTime"/> </mapping> <mapping> <identity value="objimpl"/> <map value="no-gen-base"/> </mapping> </element> <element id="Measure.lastReviewDate"> <path value="Measure.lastReviewDate"/> <short value="When the measure was last reviewed by the publisher"/> <definition value="The date on which the resource content was last reviewed. Review happens periodicallyafter approval but does not change the original approval date. Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant. .outboundRleationship[typeCode=SUBJ;subsetCode=RECENT].act[classCode=CACT;moodCode=EVN;code=review]. effectiveTime The effective period for a measure determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015. Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the measure are or are expected to be used instead.after approval but does not change the original approval date."/> <comment value="If specified, this date follows the original approval date. See guidance around (not) making local changes to elements [here](canonicalresource.html#loca lization)."/> <requirements value="Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.lastReviewDate"/> <min value="0"/> <max value="1"/> </base> <type> <code value="date"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Definition.lastReviewDate"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRleationship[typeCode=SUBJ;subsetCode=RECENT].act[classCode=CACT;moodCode=EVN;code=r eview].effectiveTime"/> </mapping> <mapping> <identity value="objimpl"/> <map value="no-gen-base"/> </mapping> </element> <element id="Measure.effectivePeriod"> <path value="Measure.effectivePeriod"/> <short value="When the measure is expected to be used"/> <definition value="The period during which the measure content was or is planned to be in active use."/> <comment value="The effective period for a measure determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015. See guidance around (not) making local changes to elements [here](canonicalresource.html#loca lization)."/> <requirements value="Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the measure are or are expected to be used instead."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.effectivePeriod"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Period"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Definition.effectivePeriod"/> </mapping> <mapping> <identity value="rim"/> <map value=".effectiveTime"/> </mapping> <mapping> <identity value="objimpl"/> <map value="no-gen-base"/> </mapping> </element> <element id="Measure.topic"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"> <valueCode value="deprecated"/> </extension> <path value="Measure.topic"/> <short value="The category of the measure, such as Education, Treatment, Assessment, etc"/> <definition value="Descriptive topics related to the content of the measure. Topics provide a high-levelcategorization grouping types of measures that can be useful for filtering and searching. Repositories must be able to determine how to categorize the measure so that it can be found by topical searches. An individiual or organization primarily involved in the creation and maintenance of the content. .participation[typeCode=AUT] { not a great match, but there does not appear to be an editor concept in V3 participation } An individual or organization responsible for officially endorsing the content for use in some setting. Each related artifact is either an attachment, or a reference to another resource, but not both. Measures must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content. .outboundRelationship[typeCode=DOC,RSON,PREV, DRIV, USE, COMP] {successor would be PREV w/ inversionInd=true; No support for citation} Notices and disclaimers regarding the use of the measure or related to intellectual property (such as code systems) referenced by the measure. Some organizations require that notices and disclosures be included when publishing measures that reference their intellecutal property. Indicates how the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort. The value set is extensible, allowing additional measure scoring types to be represented. If this is a composite measure, the scoring method used to combine the component measures to determine the composite score. 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. A description of the risk adjustment factors that may impact the resulting score for the measure and how they may be accounted for when computing and reporting measure results. Describes the method of adjusting for clinical severity and conditions present at the start of care that can influence patient outcomes for making valid comparisons of outcome measures across providers. Indicates whether a measure is subject to the statistical process for reducing, removing, or clarifying the influences of confounding factors to allow for more useful comparisons. Describes how to combine the information calculated, based on logic in each of several populations, into one summarized result.categorization grouping types of measures that can be useful for filtering and searching."/> <comment value="DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to using the new 'topic' code in the useContext element. (I.e. useContext.code indicating http://terminology.hl7.org/CodeSystem/usage-context-type#topic and useContext.valueCodeableCo ncept indicating the topic)"/> <requirements value="Repositories must be able to determine how to categorize the measure so that it can be found by topical searches."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.topic"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DefinitionTopic"/> </extension> <strength value="example"/> <description value="High-level categorization of the definition, used for searching, sorting, and filtering."/> <valueSet value="http://hl7.org/fhir/ValueSet/definition-topic"/> </binding> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.author"> <path value="Measure.author"/> <short value="Who authored the content"/> <definition value="An individiual or organization primarily involved in the creation and maintenance of the content."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.author"/> <min value="0"/> <max value="*"/> </base> <type> <code value="ContactDetail"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".participation[typeCode=AUT]"/> </mapping> </element> <element id="Measure.editor"> <path value="Measure.editor"/> <short value="Who edited the content"/> <definition value="An individual or organization primarily responsible for internal coherence of the content."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.editor"/> <min value="0"/> <max value="*"/> </base> <type> <code value="ContactDetail"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".participation[typeCode=AUT] { not a great match, but there does not appear to be an editor concept in V3 participation }"/> </mapping> </element> <element id="Measure.reviewer"> <path value="Measure.reviewer"/> <short value="Who reviewed the content"/> <definition value="An individual or organization asserted by the publisher to be primarily responsible for review of some aspect of the content."/> <comment value="See guidance around (not) making local changes to elements [here](canonicalresource.html#loca lization)."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.reviewer"/> <min value="0"/> <max value="*"/> </base> <type> <code value="ContactDetail"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".participation[typeCode=VRF] {not clear whether VRF best corresponds to reviewer or endorser}"/> </mapping> </element> <element id="Measure.endorser"> <path value="Measure.endorser"/> <short value="Who endorsed the content"/> <definition value="An individual or organization asserted by the publisher to be responsible for officially endorsing the content for use in some setting."/> <comment value="See guidance around (not) making local changes to elements [here](canonicalresource.html#loca lization)."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.endorser"/> <min value="0"/> <max value="*"/> </base> <type> <code value="ContactDetail"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".participation[typeCode=VRF] {not clear whether VRF best corresponds to reviewer or endorser}"/> </mapping> </element> <element id="Measure.relatedArtifact"> <path value="Measure.relatedArtifact"/> <short value="Additional documentation, citations, etc"/> <definition value="Related artifacts such as additional documentation, justification, or bibliographic references."/> <comment value="Each related artifact is either an attachment, or a reference to another resource, but not both."/> <requirements value="Measures must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.relatedArtifact"/> <min value="0"/> <max value="*"/> </base> <type> <code value="RelatedArtifact"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=DOC,RSON,PREV, DRIV, USE, COMP] {successor would be PREV w/ inversionInd=true; No support for citation}"/> </mapping> </element> <element id="Measure.library"> <path value="Measure.library"/> <short value="Logic used by the measure"/> <definition value="A reference to a Library resource containing the formal logic used by the measure."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.library"/> <min value="0"/> <max value="*"/> </base> <type> <code value="canonical"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Library"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.disclaimer"> <path value="Measure.disclaimer"/> <short value="Disclaimer for use of the measure or its referenced content"/> <definition value="Notices and disclaimers regarding the use of the measure or related to intellectual property (such as code systems) referenced by the measure."/> <requirements value="Some organizations require that notices and disclosures be included when publishing measures that reference their intellecutal property."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.disclaimer"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.scoring"> <path value="Measure.scoring"/> <short value="proportion | ratio | continuous-variable | cohort"/> <definition value="Indicates how the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort. The value set is extensible, allowing additional measure scoring types to be represented."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.scoring"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MeasureScoring"/> </extension> <strength value="extensible"/> <description value="The scoring type of the measure."/> <valueSet value="http://terminology.hl7.org/ValueSet/measure-scoring"/> </binding> <mapping> <identity value="rim"/> <map value=".methodCode { the aspect of how the calculation is performed }"/> </mapping> </element> <element id="Measure.scoringUnit"> <path value="Measure.scoringUnit"/> <short value="What units?"/> <definition value="Defines the expected units of measure for the measure score. This element SHOULD be specified as a UCUM unit."/> <comment value="When this element is specified, implementations are expected to report measure scores in the specified units. Note that this may involve unit conversion if the expected units are different than the units of the resulting score calculation. In this case, unit conversions SHALL be performed according to the unit conversion semantics specified by UCUM."/> <requirements value="When the unit cannot be inferred directly from the calculation logic, this element allows the specification of the desired units of measure of the output."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.scoringUnit"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MeasureScoringUnit"/> </extension> <strength value="example"/> <valueSet value="http://hl7.org/fhir/ValueSet/measure-scoring-unit"/> </binding> <mapping> <identity value="rim"/> <map value=".methodCode { the aspect of how the calculation is performed }"/> </mapping> </element> <element id="Measure.compositeScoring"> <path value="Measure.compositeScoring"/> <short value="opportunity | all-or-nothing | linear | weighted"/> <definition value="If this is a composite measure, the scoring method used to combine the component measures to determine the composite score."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.compositeScoring"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="CompositeMeasureScoring"/> </extension> <strength value="extensible"/> <description value="The composite scoring method of the measure."/> <valueSet value="http://hl7.org/fhir/ValueSet/composite-measure-scoring"/> </binding> <mapping> <identity value="rim"/> <map value=".methodCode { the aspect of how component measures are combined }"/> </mapping> </element> <element id="Measure.type"> <path value="Measure.type"/> <short value="process | outcome | structure | patient-reported-outcome | composite"/> <definition value="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."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.type"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MeasureType"/> </extension> <strength value="extensible"/> <description value="The type of measure (includes codes from 2.16.840.1.113883.1.11.20368)."/> <valueSet value="http://hl7.org/fhir/ValueSet/measure-type"/> </binding> <mapping> <identity value="rim"/> <map value=".methodCode { the aspect of what the measure applies to }"/> </mapping> </element> <element id="Measure.riskAdjustment"> <path value="Measure.riskAdjustment"/> <short value="How risk adjustment is applied for this measure"/> <definition value="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."/> <comment value="Describes the method of adjusting for clinical severity and conditions present at the start of care that can influence patient outcomes for making valid comparisons of outcome measures across providers. Indicates whether a measure is subject to the statistical process for reducing, removing, or clarifying the influences of confounding factors to allow for more useful comparisons."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.riskAdjustment"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.rateAggregation"> <path value="Measure.rateAggregation"/> <short value="How is rate aggregation performed for this measure"/> <definition value="Describes how to combine the information calculated, based on logic in each of several populations, into one summarized result."/> <comment value="The measure rate for an organization or clinician is based upon the entities’ aggregatedata and summarizes the performance of the entity over a given time period (e.g., monthly, quarterly, yearly). The aggregated data are derived from the results of a specific measure algorithm and, if appropriate, the application of specific risk adjustment models. Can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure (e.g., pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two). This could be applied to aggregated cohort measure definitions (e.g., CDC's aggregate reporting for TB at the state level).data and summarizes the performance of the entity over a given time period (e.g., monthly, quarterly, yearly). The aggregated data are derived from the results of a specific measure algorithm and, if appropriate, the application of specific risk adjustment models. Can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure (e.g., pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two). This could be applied to aggregated cohort measure definitions (e.g., CDC's aggregate reporting for TB at the state level)."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.rateAggregation"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.rationale"> <path value="Measure.rationale"/> <short value="Detailed description of why the measure exists"/> <definition value="Provides a succinct statement of the need for the measure. Usually includes statementspertaining to importance criterion: impact, gap in care, and evidence. Measure developers need to be able to provide a detailed description of the purpose of the measure. This element provides detailed rationale, where the purpose element provides a summary of the rationale. Provides a summary of relevant clinical guidelines or other clinical recommendations supporting the measure. Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range). Measure consumers and implementers must be able to determine how to interpret a measure score. Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue. Measure developers must be able to provide precise definitions of terms used within measure descriptions and guidance to help communicate the intent of the measure. Additional guidance for the measure including how it can be used in a clinical context, and the intent of the measure. Measure developers must be able to provide additional guidance for implementers to understand the intent with greater specificity than that provided in the population criteria of the measure. This element provides detailed guidance, where the usage element provides a summary of the guidance. Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.pertaining to importance criterion: impact, gap in care, and evidence."/> <requirements value="Measure developers need to be able to provide a detailed description of the purpose of the measure. This element provides detailed rationale, where the purpose element provides a summary of the rationale."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.rationale"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.clinicalRecommendationStatement"> <path value="Measure.clinicalRecommendationStatement"/> <short value="Summary of clinical guidelines"/> <definition value="Provides a summary of relevant clinical guidelines or other clinical recommendations supporting the measure."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.clinicalRecommendationStatement"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.improvementNotation"> <path value="Measure.improvementNotation"/> <short value="increase | decrease"/> <definition value="Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range)."/> <requirements value="Measure consumers and implementers must be able to determine how to interpret a measure score."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.improvementNotation"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MeasureImprovementNotation"/> </extension> <strength value="required"/> <description value="Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue."/> <valueSet value="http://hl7.org/fhir/ValueSet/measure-improvement-notation|5.0.0"/> </binding> <mapping> <identity value="rim"/> <map value=".interpretationCode"/> </mapping> </element> <element id="Measure.term"> <path value="Measure.term"/> <short value="Defined terms used in the measure documentation"/> <definition value="Provides a description of an individual term used within the measure."/> <requirements value="Measure developers must be able to provide precise definitions of terms used within measure descriptions and guidance to help communicate the intent of the measure."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.term"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Measure.term.id"> <path value="Measure.term.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Measure.term.extension"> <path value="Measure.term.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definitionof the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Measure.term.modifierExtension"> <path value="Measure.term.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="May be used to represent additional information that is not part of the basic definitionof the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.ht ml#modifierExtension). Modifier extensions are expected to modify the meaning or interpretation of the element that contains them Indicates a meaning for the group. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing groups to be correlated across measures. Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Measure.term.code"> <path value="Measure.term.code"/> <short value="What term?"/> <definition value="A codeable representation of the defined term."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.term.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DefinitionCode"/> </extension> <strength value="example"/> <description value="Codeable representations of measure definition terms."/> <valueSet value="http://hl7.org/fhir/ValueSet/measure-definition-example"/> </binding> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Measure.term.definition"> <path value="Measure.term.definition"/> <short value="Meaning of the term"/> <definition value="Provides a definition for the term as used within the measure."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.term.definition"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.guidance"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"> <valueCode value="deprecated"/> </extension> <path value="Measure.guidance"/> <short value="Additional guidance for implementers (deprecated)"/> <definition value="Additional guidance for the measure including how it can be used in a clinical context, and the intent of the measure."/> <comment value="NOTE: This element is deprecated in favor of the usage element"/> <requirements value="Measure developers must be able to provide additional guidance for implementers to understand the intent with greater specificity than that provided in the population criteria of the measure. This element provides detailed guidance, where the usage element provides a summary of the guidance."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.guidance"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.group"> <path value="Measure.group"/> <short value="Population criteria group"/> <definition value="A group of population criteria for the measure."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.group"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <condition value="mea-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=COMP]"/> </mapping> </element> <element id="Measure.group.id"> <path value="Measure.group.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Measure.group.extension"> <path value="Measure.group.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definitionof the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Measure.group.modifierExtension"> <path value="Measure.group.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="May be used to represent additional information that is not part of the basic definitionof the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.ht ml#modifierExtension). Modifier extensions are expected to modify the meaning or interpretation of the element that contains themof the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Measure.group.linkId"> <path value="Measure.group.linkId"/> <short value="Unique id for group in measure"/> <definition value="An identifier that is unique within the Measure allowing linkage to the equivalent item in a MeasureReport resource."/> <comment value="This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here. LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such"/> <requirements value="[MeasureReport](measurereport.html#) does not require omitted groups to be included."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.linkId"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="mea-2"/> <severity value="warning"/> <human value="Link ids should be 255 characters or less"/> <expression value="$this.length() <= 255"/> <source value="http://hl7.org/fhir/StructureDefinition/Measure"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".id"/> </mapping> </element> <element id="Measure.group.code"> <path value="Measure.group.code"/> <short value="Meaning of the group"/> <definition value="Indicates a meaning for the group. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing groups to be correlated across measures."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MeasureGroupExample"/> </extension> <strength value="example"/> <description value="Example of measure groups."/> <valueSet value="http://hl7.org/fhir/ValueSet/measure-group-example"/> </binding> <mapping> <identity value="rim"/> <map value=".code"/> </mapping> </element> <element id="Measure.group.description"> <path value="Measure.group.description"/> <short value="Summary description"/> <definition value="The human readable description of this population group."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.description"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".text"/> </mapping> </element> <element id="Measure.group.type"> <path value="Measure.group.type"/> <short value="process | outcome | structure | patient-reported-outcome | composite"/> <definition value="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."/> <comment value="When specified at the group level, defines the measure type for this specific group. If not specified, the measureType of the group is determined by the root type element"/> <min value="0"/> <max value="*"/> <base> <path value="Measure.group.type"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MeasureType"/> </extension> <strength value="extensible"/> <valueSet value="http://hl7.org/fhir/ValueSet/measure-type"/> </binding> <mapping> <identity value="rim"/> <map value=".typeCode"/> </mapping> </element> <element id="Measure.group.subject[x]"> <path value="Measure.group.subject[x]"/> <short value="E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device"/> <definition value="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."/> <comment value="The subject of the measure is critical in interpreting the criteria definitions, as the logic in the measures is evaluated with respect to a particular subject. This corresponds roughly to the notion of a Compartment in that it limits what content is available based on its relationship to the subject. In CQL, this corresponds to the context declaration."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.subject[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> </type> <meaningWhenMissing value="Patient"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="SubjectType"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="extensible"/> <description value="The possible types of subjects for a measure (E.g. Patient, Practitioner, Organization, Location, etc.)."/> <valueSet value="http://hl7.org/fhir/ValueSet/participant-resource-types"/> </binding> <mapping> <identity value="rim"/> <map value="N/A (to add?) { only applies for subject Patient? }"/> </mapping> </element> <element id="Measure.group.basis"> <path value="Measure.group.basis"/> <short value="Population basis"/> <definition value="The population basis specifies the type of elements in the population. For a subject-based measure, this is boolean (because the subject and the population basis are the same, and the population criteria define yes/no values for each individual in the population). For measures that have a population basis that is different than the subject, this element specifies the type of the population basis. For example, an encounter-based measure has a subject of Patient and a population basis of Encounter, and the population criteria all return lists of Encounters."/> <comment value="When specified at the group level, defines the population basis for this specific group. If not specified, the basis for the group is determined by the root basis element"/> <requirements value="Allows non-subject-based measures to be specified"/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.basis"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <meaningWhenMissing value="boolean"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BasisType"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="required"/> <valueSet value="http://hl7.org/fhir/ValueSet/fhir-types|5.0.0"/> </binding> <mapping> <identity value="rim"/> <map value="N/A (to add?) { only applies for subject Patient? }"/> </mapping> </element> <element id="Measure.group.scoring"> <path value="Measure.group.scoring"/> <short value="proportion | ratio | continuous-variable | cohort"/> <definition value="Indicates how the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort. The value set is extensible, allowing additional measure scoring types to be represented."/> <comment value="When specified at the group level, defines the scoring for this specific group. If not specified, scoring for this group is determined by the root scoring element"/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.scoring"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MeasureScoring"/> </extension> <strength value="extensible"/> <valueSet value="http://terminology.hl7.org/ValueSet/measure-scoring"/> </binding> <mapping> <identity value="rim"/> <map value=".methodCode { the aspect of how the calculation is performed }"/> </mapping> </element> <element id="Measure.group.scoringUnit"> <path value="Measure.group.scoringUnit"/> <short value="What units?"/> <definition value="Defines the expected units of measure for the measure score. This element SHOULD be specified as a UCUM unit."/> <comment value="When specified at the group level, this defines the scoringUnit for this specific group. If not specified, the scoringUnit for this group is determined by the root scoringUnit element. As with the root element, when this element is specified, implementations are expected to report measure scores in the specified units. Note that this may involve unit conversion if the expected units are different than the units of the resulting score calculation. In this case, unit conversions SHALL be performed according to the unit conversion semantics specified by UCUM."/> <requirements value="When the unit cannot be inferred directly from the calculation logic, this element allows the specification of the desired units of measure of the output."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.scoringUnit"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MeasureScoringUnit"/> </extension> <strength value="example"/> <valueSet value="http://hl7.org/fhir/ValueSet/measure-scoring-unit"/> </binding> <mapping> <identity value="rim"/> <map value=".methodCode { the aspect of how the calculation is performed }"/> </mapping> </element> <element id="Measure.group.rateAggregation"> <path value="Measure.group.rateAggregation"/> <short value="How is rate aggregation performed for this measure"/> <definition value="Describes how to combine the information calculated, based on logic in each of several populations, into one summarized result."/> <comment value="The measure rate for an organization or clinician is based upon the entities’ aggregate data and summarizes the performance of the entity over a given time period (e.g., monthly, quarterly, yearly). The aggregated data are derived from the results of a specific measure algorithm and, if appropriate, the application of specific risk adjustment models. Can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure (e.g., pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two). This could be applied to aggregated cohort measure definitions (e.g., CDC's aggregate reporting for TB at the state level)."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.rateAggregation"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.group.improvementNotation"> <path value="Measure.group.improvementNotation"/> <short value="increase | decrease"/> <definition value="Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range)."/> <comment value="When specified at the group level, this element defines the improvementNotation for this specific group. If not specified, improvementNotation for this group is determined by the root improvementNotation element"/> <requirements value="Measure consumers and implementers must be able to determine how to interpret a measure score."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.improvementNotation"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MeasureImprovementNotation"/> </extension> <strength value="required"/> <valueSet value="http://hl7.org/fhir/ValueSet/measure-improvement-notation|5.0.0"/> </binding> <mapping> <identity value="rim"/> <map value=".methodCode { the aspect of how the calculation is performed }"/> </mapping> </element> <element id="Measure.group.library"> <path value="Measure.group.library"/> <short value="Logic used by the measure group"/> <definition value="A reference to a Library resource containing the formal logic used by the measure group."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.group.library"/> <min value="0"/> <max value="*"/> </base> <type> <code value="canonical"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Library"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.group.population"> <path value="Measure.group.population"/> <short value="Population criteria"/> <definition value="A population criteria for the measure."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.group.population"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=COMP]"/> </mapping> </element> <element id="Measure.group.population.id"> <path value="Measure.group.population.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Measure.group.population.extension"> <path value="Measure.group.population.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Measure.group.population.modifierExtension"> <path value="Measure.group.population.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Measure.group.population.linkId"> <path value="Measure.group.population.linkId"/> <short value="Unique id for population in measure"/> <definition value="An identifier that is unique within the Measure allowing linkage to the equivalent population in a MeasureReport resource."/> <comment value="This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here. LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such"/> <requirements value="[MeasureReport](measurereport.html#) does not require omitted populations to be included."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.population.linkId"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="mea-3"/> <severity value="warning"/> <human value="Link ids should be 255 characters or less"/> <expression value="$this.length() <= 255"/> <source value="http://hl7.org/fhir/StructureDefinition/Measure"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".id"/> </mapping> </element> <element id="Measure.group.population.code"> <path value="Measure.group.population.code"/> <short value="initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion| denominator-exception | measure-population | measure-population-exclusion | measure-observation An expression that specifies the criteria for the population, typically the name of an expression in a library. In the case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information. The stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library or a valid FHIR Resource Path. Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.| denominator-exception | measure-population | measure-population-exclusion | measure-observa tion"/> <definition value="The type of population criteria."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.population.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MeasurePopulationType"/> </extension> <strength value="extensible"/> <description value="The type of population."/> <valueSet value="http://hl7.org/fhir/ValueSet/measure-population"/> </binding> <mapping> <identity value="rim"/> <map value=".code"/> </mapping> </element> <element id="Measure.group.population.description"> <path value="Measure.group.population.description"/> <short value="The human readable description of this population criteria"/> <definition value="The human readable description of this population criteria."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.population.description"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".text"/> </mapping> </element> <element id="Measure.group.population.criteria"> <path value="Measure.group.population.criteria"/> <short value="The criteria that defines this population"/> <definition value="An expression that specifies the criteria for the population, typically the name of an expression in a library."/> <comment value="In the case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.population.criteria"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Expression"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.group.population.groupDefinition"> <path value="Measure.group.population.groupDefinition"/> <short value="A group resource that defines this population"/> <definition value="A Group resource that defines this population as a set of characteristics."/> <comment value="Note that this approach can only be used for measures where the basis is of the same type as the populations (e.g. a Patient-based measure, rather than an Encounter-based measure). In addition, the referenced Group resource SHALL be a definitional (as opposed to an actual) group."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.population.groupDefinition"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.group.population.inputPopulationId"> <path value="Measure.group.population.inputPopulationId"/> <short value="Which population"/> <definition value="The id of a population element in this measure that provides the input for this population criteria. In most cases, the scoring structure of the measure implies specific relationships (e.g. the Numerator uses the Denominator as the source in a proportion scoring). In some cases, however, multiple possible choices exist and must be resolved explicitly. For example in a ratio measure with multiple initial populations, the denominator must specify which population should be used as the starting point."/> <requirements value="For ratio and continuous variable measures, the source populations must be specified explicitly when they cannot be unambiguously determined from the scoring structure."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.population.inputPopulationId"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.group.population.aggregateMethod"> <path value="Measure.group.population.aggregateMethod"/> <short value="Aggregation method for a measure score (e.g. sum, average, median, minimum, maximum, count)"/> <definition value="Specifies which method should be used to aggregate measure observation values. For most scoring types, this is implied by scoring (e.g. a proportion measure counts members of the populations). For continuous variables, however, this information must be specified to ensure correct calculation."/> <requirements value="For continuous variable measures, specifications must be able to indicate the aggregation method to be used for tallying results from individual observations."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.population.aggregateMethod"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MeasureAggregateMethod"/> </extension> <strength value="extensible"/> <valueSet value="http://hl7.org/fhir/ValueSet/measure-aggregate-method"/> </binding> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.group.stratifier"> <path value="Measure.group.stratifier"/> <short value="Stratifier criteria for the measure"/> <definition value="The stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library or a valid FHIR Resource Path."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.group.stratifier"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <condition value="mea-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=COMP]"/> </mapping> </element> <element id="Measure.group.stratifier.id"> <path value="Measure.group.stratifier.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Measure.group.stratifier.extension"> <path value="Measure.group.stratifier.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definitionof the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Measure.group.stratifier.modifierExtension"> <path value="Measure.group.stratifier.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="May be used to represent additional information that is not part of the basic definitionof the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.ht ml#modifierExtension). Modifier extensions are expected to modify the meaning or interpretation of the element that contains themof the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Measure.group.stratifier.linkId"> <path value="Measure.group.stratifier.linkId"/> <short value="Unique id for stratifier in measure"/> <definition value="An identifier that is unique within the Measure allowing linkage to the equivalent item in a MeasureReport resource."/> <comment value="This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here. LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such"/> <requirements value="[MeasureReport](measurereport.html#) does not require omitted stratifiers to be included."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.stratifier.linkId"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="mea-4"/> <severity value="warning"/> <human value="Link ids should be 255 characters or less"/> <expression value="$this.length() <= 255"/> <source value="http://hl7.org/fhir/StructureDefinition/Measure"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".id"/> </mapping> </element> <element id="Measure.group.stratifier.code"> <path value="Measure.group.stratifier.code"/> <short value="Meaning of the stratifier"/> <definition value="Indicates a meaning for the stratifier. This can be as simple as a unique identifier,or it can establish meaning in a broader context by drawing from a terminology, allowing stratifiers to be correlated across measures. An expression that specifies the criteria for the stratifier. This is typically the name of an expression defined within a referenced library, but it may also be a path to a stratifier element. A component of the stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library or a valid FHIR Resource Path. Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.or it can establish meaning in a broader context by drawing from a terminology, allowing stratifiers to be correlated across measures."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.stratifier.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <condition value="mea-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MeasureStratifierExample"/> </extension> <strength value="example"/> <description value="Meaning of the stratifier."/> <valueSet value="http://hl7.org/fhir/ValueSet/measure-stratifier-example"/> </binding> <mapping> <identity value="rim"/> <map value=".code"/> </mapping> </element> <element id="Measure.group.stratifier.description"> <path value="Measure.group.stratifier.description"/> <short value="The human readable description of this stratifier"/> <definition value="The human readable description of this stratifier criteria."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.stratifier.description"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <condition value="mea-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".text"/> </mapping> </element> <element id="Measure.group.stratifier.criteria"> <path value="Measure.group.stratifier.criteria"/> <short value="How the measure should be stratified"/> <definition value="An expression that specifies the criteria for the stratifier. This is typically the name of an expression defined within a referenced library, but it may also be a path to a stratifier element."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.stratifier.criteria"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Expression"/> </type> <condition value="mea-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.group.stratifier.groupDefinition"> <path value="Measure.group.stratifier.groupDefinition"/> <short value="A group resource that defines this population"/> <definition value="A Group resource that defines this population as a set of characteristics."/> <comment value="Note that this approach can only be used for measures where the basis is of the same type as the populations (e.g. a Patient-based measure, rather than an Encounter-based measure). In addition, the referenced Group SHALL be a definitional (as opposed to an actual) group."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.stratifier.groupDefinition"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.group.stratifier.component"> <path value="Measure.group.stratifier.component"/> <short value="Stratifier criteria component for the measure"/> <definition value="A component of the stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library or a valid FHIR Resource Path."/> <comment value="Stratifiers are defined either as a single criteria, or as a set of component criteria."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.group.stratifier.component"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <condition value="mea-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=COMP]"/> </mapping> </element> <element id="Measure.group.stratifier.component.id"> <path value="Measure.group.stratifier.component.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Measure.group.stratifier.component.extension"> <path value="Measure.group.stratifier.component.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definitionof the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Measure.group.stratifier.component.modifierExtension"> <path value="Measure.group.stratifier.component.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="May be used to represent additional information that is not part of the basic definitionof the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.ht ml#modifierExtension). Modifier extensions are expected to modify the meaning or interpretation of the element that contains them Indicates a meaning for the stratifier component. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing stratifiers to be correlated across measures. An expression that specifies the criteria for this component of the stratifier. This is typically the name of an expression defined within a referenced library, but it may also be a path to a stratifier element. The supplemental data criteria for the measure report, specified as either the name of a valid CQL expression within a referenced library, or a valid FHIR Resource Path. Note that supplemental data are reported as observations for each patient and included in the evaluatedResources bundle. See the MeasureReport resource or the Quality Reporting topic for more information. Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Measure.group.stratifier.component.linkId"> <path value="Measure.group.stratifier.component.linkId"/> <short value="Unique id for stratifier component in measure"/> <definition value="An identifier that is unique within the Measure allowing linkage to the equivalent item in a MeasureReport resource."/> <comment value="This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here. LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such"/> <requirements value="[MeasureReport](measurereport.html#) does not require omitted stratifier components to be included."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.stratifier.component.linkId"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="mea-5"/> <severity value="warning"/> <human value="Link ids should be 255 characters or less"/> <expression value="$this.length() <= 255"/> <source value="http://hl7.org/fhir/StructureDefinition/Measure"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".id"/> </mapping> </element> <element id="Measure.group.stratifier.component.code"> <path value="Measure.group.stratifier.component.code"/> <short value="Meaning of the stratifier component"/> <definition value="Indicates a meaning for the stratifier component. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing stratifiers to be correlated across measures."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.stratifier.component.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MeasureStratifierExample"/> </extension> <strength value="example"/> <description value="Meaning of the stratifier."/> <valueSet value="http://hl7.org/fhir/ValueSet/measure-stratifier-example"/> </binding> <mapping> <identity value="rim"/> <map value=".code"/> </mapping> </element> <element id="Measure.group.stratifier.component.description"> <path value="Measure.group.stratifier.component.description"/> <short value="The human readable description of this stratifier component"/> <definition value="The human readable description of this stratifier criteria component."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.stratifier.component.description"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".text"/> </mapping> </element> <element id="Measure.group.stratifier.component.criteria"> <path value="Measure.group.stratifier.component.criteria"/> <short value="Component of how the measure should be stratified"/> <definition value="An expression that specifies the criteria for this component of the stratifier. This is typically the name of an expression defined within a referenced library, but it may also be a path to a stratifier element."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.stratifier.component.criteria"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Expression"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.group.stratifier.component.groupDefinition"> <path value="Measure.group.stratifier.component.groupDefinition"/> <short value="A group resource that defines this population"/> <definition value="A Group resource that defines this population as a set of characteristics."/> <comment value="Note that this approach can only be used for measures where the basis is of the same type as the populations (e.g. a Patient-based measure, rather than an Encounter-based measure). In addition, the referenced Group SHALL be a definitional (as opposed to an actual) group."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.group.stratifier.component.groupDefinition"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> <element id="Measure.supplementalData"> <path value="Measure.supplementalData"/> <short value="What other data should be reported with the measure"/> <definition value="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."/> <comment value="Note that supplemental data are reported as resources for each patient and referenced in the supplementalData element of the MeasureReport. If the supplementalData expression results in a value other than a resource, it is reported using an Observation resource, typically contained in the resulting MeasureReport. See the MeasureReport resource and the Quality Reporting topic for more information."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.supplementalData"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=COMP]"/> </mapping> </element> <element id="Measure.supplementalData.id"> <path value="Measure.supplementalData.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Measure.supplementalData.extension"> <path value="Measure.supplementalData.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definitionof the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Measure.supplementalData.modifierExtension"> <path value="Measure.supplementalData.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="May be used to represent additional information that is not part of the basic definitionof the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.ht ml#modifierExtension). Modifier extensions are expected to modify the meaning or interpretation of the element that contains them Indicates a meaning for the supplemental data. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing supplemental data to be correlated across measures. An indicator of the intended usage for the supplemental data element. Supplemental data indicates the data is additional information requested to augment the measure information. Risk adjustment factor indicates the data is additional information used to calculate risk adjustment factors when applying a risk model to the measure calculation.of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Measure.supplementalData.linkId"> <path value="Measure.supplementalData.linkId"/> <short value="Unique id for supplementalData in measure"/> <definition value="An identifier that is unique within the Measure allowing linkage to the equivalent item in a MeasureReport resource."/> <comment value="This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here. LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such"/> <requirements value="[MeasureReport](measurereport.html#) does not require omitted supplementalData to be included."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.supplementalData.linkId"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="mea-6"/> <severity value="warning"/> <human value="Link ids should be 255 characters or less"/> <expression value="$this.length() <= 255"/> <source value="http://hl7.org/fhir/StructureDefinition/Measure"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".id"/> </mapping> </element> <element id="Measure.supplementalData.code"> <path value="Measure.supplementalData.code"/> <short value="Meaning of the supplemental data"/> <definition value="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."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.supplementalData.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MeasureSupplementalDataExample"/> </extension> <strength value="example"/> <description value="Meaning of the supplemental data."/> <valueSet value="http://hl7.org/fhir/ValueSet/measure-supplemental-data-example"/> </binding> <mapping> <identity value="rim"/> <map value=".code"/> </mapping> </element> <element id="Measure.supplementalData.usage"> <path value="Measure.supplementalData.usage"/> <short value="supplemental-data | risk-adjustment-factor"/> <definition value="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."/> <min value="0"/> <max value="*"/> <base> <path value="Measure.supplementalData.usage"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MeasureDataUsage"/> </extension> <strength value="extensible"/> <description value="The intended usage for supplemental data elements in the measure."/> <valueSet value="http://hl7.org/fhir/ValueSet/measure-data-usage"/> </binding> <mapping> <identity value="rim"/> <map value=".methodCode"/> </mapping> </element> <element id="Measure.supplementalData.description"> <path value="Measure.supplementalData.description"/> <short value="The human readable description of this supplemental data"/> <definition value="The human readable description of this supplemental data."/> <min value="0"/> <max value="1"/> <base> <path value="Measure.supplementalData.description"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".text"/> </mapping> </element> <element id="Measure.supplementalData.criteria"> <path value="Measure.supplementalData.criteria"/> <short value="Expression describing additional data to be reported"/> <definition value="The criteria for the supplemental data. This is typically the name of a valid expressiondefined within a referenced library, but it may also be a path to a specific data element. The criteria defines the data to be returned for this element.defined within a referenced library, but it may also be a path to a specific data element. The criteria defines the data to be returned for this element."/> <min value="1"/> <max value="1"/> <base> <path value="Measure.supplementalData.criteria"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Expression"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A (to add?)"/> </mapping> </element> </snapshot> <differential> <element id="Measure"> <path value="Measure"/> <min value="1"/> <max value="1"/> </element> <element id="Measure.extension:knowledgeCapability"> <path value="Measure.extension"/> <sliceName value="knowledgeCapability"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability"/> </type> <mustSupport value="true"/> </element> <element id="Measure.extension:knowledgeRepresentationLevel"> <path value="Measure.extension"/> <sliceName value="knowledgeRepresentationLevel"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeRepresentationLevel"/> </type> <mustSupport value="true"/> </element> <element id="Measure.extension:artifactComment"> <path value="Measure.extension"/> <sliceName value="artifactComment"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/StructureDefinition/cqf-artifactComment"/> </type> <mustSupport value="true"/> </element> <element id="Measure.url"> <path value="Measure.url"/> <min value="1"/> <max value="1"/> <mustSupport value="true"/> </element> <element id="Measure.version"> <path value="Measure.version"/> <min value="1"/> <max value="1"/> <mustSupport value="true"/> </element> <element id="Measure.versionAlgorithm[x]"> <path value="Measure.versionAlgorithm[x]"/> <mustSupport value="true"/> </element> <element id="Measure.name"> <path value="Measure.name"/> <mustSupport value="true"/> </element> <element id="Measure.title"> <path value="Measure.title"/> <min value="1"/> <max value="1"/> <mustSupport value="true"/> </element> <element id="Measure.experimental"> <path value="Measure.experimental"/> <mustSupport value="true"/> </element> <element id="Measure.publisher"> <path value="Measure.publisher"/> <mustSupport value="true"/> </element> <element id="Measure.description"> <path value="Measure.description"/> <min value="1"/> <max value="1"/> <mustSupport value="true"/> </element> </differential> </ StructureDefinition >
FHIR
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FHIR
Release
4B
(v4.3.0)
hl7.fhir.r4b.core#4.3.0
R5
hl7.fhir.core#5.0.0
generated
on
Sat,
May
28,
2022
12:56+1000.
Sun,
Mar
26,
2023
15:25+1100.
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