The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. Control 0..1 Type Meta Composition.implicitRules Definition A reference to a set of rules that were followed when the MeasureReport resource was constructed, and which must be understood when processing the content. Control 0..1 Type uri Is Modifier true Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits contains the usefulness results 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 evaluating a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible. Composition.language Definition The base language in which the resource is written. measure.

A human-readable narrative formal identifier that contains a summary of the resource, and may 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 used to make identify this report when it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be is represented in the narrative to ensure clinical safety. Control 0..1 This element is affected by the following invariants: dom-1 Type Narrative Alternate Names narrative, html, xhtml, display Comments Contained resources do not have narrative. Resources that are not contained SHOULD have other formats, or referenced in a narrative. Composition.contained Definition These resources do not have specification, model, design or 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. instance.

There can Allows externally provided and/or usable business identifiers to be no stigma easily 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. Composition.modifierExtension Definition May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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. module.

There Typically, this is used for identifiers that can be no stigma associated with the use of extensions by any application, project, or standard go in an HL7 v3 II data type - regardless e.g. to identify this {{title}} outside of FHIR, where the institution or jurisdiction that uses or defines the extensions. The use of extensions logical URL is what allows the FHIR specification not possible to retain a core level of simplicity for everyone. use.

Logical Identifier for the composition, assigned when created. This identifier stays constant as The report status. No data will be available until the composition report status is changed over time. complete.

A categorization for the The type of the composition. measure report. This may be implied by or derived from the code specified in the Composition Type. Control 0..1 Binding High-level kind of a clinical document at a macro level. For example codes, see FHIR Document Class Codes Type CodeableConcept Requirements Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents. Comments This is individual report, which provides a metadata field from XDS/MHD . Composition.title Definition Official human-readable label single patient's score for the composition. Control 1..1 Type string Comments For many compositions, measure; a patient listing, which returns the title is list of patients that meet the same as various criteria in the text measure; or a display name of Composition.type (e.g. summary report, which returns a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful population count for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period. Composition.status Definition The workflow/clinical status each of this composition. The status is a marker for the clinical standing of criteria in the document. measure.

If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "withdrawn" is why this This element is labeled as a modifier of other elements. Some reporting work flows require that because the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required. Composition.confidentiality Definition The code specifying the level of confidentiality of the Composition. Control 1..1 Binding Codes specifying the level of confidentiality of the composition. The contains codes SHALL be taken from v3 Code System Confidentiality Type code Is Modifier true Comments The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for that mark the base specification, and delegated to implementation profiles (see security section). resource as not currently valid.

Who or what A reference to the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (I.e. machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients Measure that share a common exposure). was evaluated to produce this report.

Identifies who is responsible for the information in Optional Patient if the composition. (Not necessarily who typed it in.). report was requested for a single patient.

unique id for the element within a resource (for internal references). The date this measure report was generated.

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 that contains it. Usually modifier elements provide negation or qualification. In order 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. Reporting Organization.

The type of attestation reporting period for which the authenticator offers. report was calculated.

Who attested The results of the composition calculation, one for each population group in the specified way. measure.

Identifies the organization or group who is responsible for ongoing maintenance The identifier of and access to the composition/document information. Control 0..1 Type Reference ( Organization ) Requirements Identifies where to go to find population group as defined in the current version, where to report issues, etc. measure definition.

unique id The populations that make up the population group, one for each type of population appropriate for the element within a resource (for internal references). measure.

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set The identifier 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 population being reported, as part of the definition of the extension. Control 0..* Type Extension Alternate Names extensions, user content Comments There can be no stigma associated with the use of extensions defined by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use population element of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. measure.

This list The type of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act. population.

The period number of members of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time. population.

Full details This element refers to a List of patient level MeasureReport resources, one for the event(s) the composition/documentation consents. each patient in this population.

Describes The measure score for this population group, calculated as appropriate for the clinical encounter or measure type and scoring method, and based on the contents of care this documentation is associated with. the populations defined in the group.

The root of the contents that make up When a measure includes multiple stratifiers, there will be a stratifier group for each stratifier defined by the composition. measure.

unique id for The identifier of this stratifier, as defined in the element within a resource (for internal references). measure definition.

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 This element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is results for a strict set of governance applied to single stratum within the definition and use of extensions. Though any implementer is allowed to define an extension, stratifier. For example, when stratifying on administrative gender, there is a set of requirements that SHALL will be met as part of the definition of the extension. Applications processing a resource are required to check four strata, one for modifier extensions. each possible gender value.

The heading value for this particular section. This will be part of stratum, expressed as a string. When defining stratifiers on complex values, the value must be rendered content such that the value for each stratum within the document. stratifier is unique.

A code identifying The populations that make up the kind stratum, one for each type of content contained within the section. This must be consistent with population appropriate to the section title. measure.

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation identifier of the resource that is population being reported, as defined by the content population element of the section in the comments for the section.code. measure.

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list The type of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted. the population.

Specifies the order applied to The number of members of the items population in the section entries. this stratum.

The content (narrative and data) associated with the section. This element refers to a List of patient level MeasureReport resources, one for each patient in this population in this stratum.

If the section is empty, why The measure score for this stratum, calculated as appropriate for the list is empty. An empty section typically has some text explaining measure type and scoring method, and based on only the empty reason. members of this stratum.

A nested sub-section within reference to a Bundle containing the Resources that were used in the evaluation of this section. report.