Quality Measure Implementation Guide (STU5)
5.0.0-ballot2 - ballot United States of America flag

Quality Measure Implementation Guide (STU5), published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 5.0.0-ballot2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cqf-measures/ and changes regularly. See the Directory of published versions

Resource Profile: CQFMPublishableMeasure - Detailed Descriptions

Active as of 2024-04-09

Definitions for the publishable-measure-cqfm resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Measure
Must Supportfalse
Invariantspmp-0: The tail (meaning everything after the last slash in the URL) of the canonical URL of the Measure resource SHALL match the name of the Measure (url.repeat(substring(indexOf('/')+1,length())).last() = id)
2. Measure.text
Control1..1
Must Supporttrue
Requirements

A published measure must provide human-readable narrative description of the measure contents.

4. Measure.extension:supplementalDataGuidance
Slice NamesupplementalDataGuidance
Control0..*
TypeExtension(CQFM Supplemental Data Guidance) (Complex Extension)
Must Supporttrue
6. Measure.extension:comment
Slice Namecomment
Definition

A comment containing additional documentation, a review comment, usage guidance, or other relevant information from a particular user.

ShortAdditional documentation, review, or usage guidance
Control0..*
TypeExtension(Artifact Comment) (Complex Extension)
Is Modifierfalse
Must Supporttrue
8. Measure.extension:softwaresystem
Slice Namesoftwaresystem
Definition

Specifies the software systems used in the packaging and testing of measure and library resources. Specifically to know which version of what software was used.

ShortExtension
Control0..*
TypeExtension(CRMI Software System) (Extension Type: Reference(CRMI Software System Device))
Is Modifierfalse
Must Supporttrue
10. Measure.extension:improvementNotationGuidance
Slice NameimprovementNotationGuidance
Control0..1
TypeExtension(CQFM Improvement Notation) (Extension Type: CodeableConcept)
Must Supporttrue
12. Measure.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control3..*
TypeIdentifier
Must Supporttrue
Requirements

A published measure must be able to specify additional identifiers such as endorser and publisher identifiers for the measure.

SlicingThis element introduces a set of slices on Measure.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ type
  • 14. Measure.identifier:versionIndependentIdentifier
    Slice NameversionIndependentIdentifier
    Definition

    The version-independent globally unique identifier for the measure (GUID).

    ShortMeasure guid
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control1..1
    Must Supporttrue
    16. Measure.identifier:versionIndependentIdentifier.use
    Control1..1
    Typecode
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Fixed Valueofficial
    18. Measure.identifier:versionIndependentIdentifier.type
    Control1..1
    TypeCodeableConcept
    Must Supporttrue
    Pattern Value{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
        "code" : "version-independent"
      }]
    }
    20. Measure.identifier:versionIndependentIdentifier.system
    Control1..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Fixed Valueurn:ietf:rfc:3986
    22. Measure.identifier:versionIndependentIdentifier.value
    Control1..1
    Must Supporttrue
    24. Measure.identifier:versionSpecificIdentifier
    Slice NameversionSpecificIdentifier
    Definition

    The version-specific globally unique identifier for the measure (GUID).

    ShortMeasure version guid
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control1..1
    Must Supporttrue
    26. Measure.identifier:versionSpecificIdentifier.use
    Control1..1
    Typecode
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Fixed Valueofficial
    28. Measure.identifier:versionSpecificIdentifier.type
    Control1..1
    TypeCodeableConcept
    Must Supporttrue
    Pattern Value{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
        "code" : "version-specific"
      }]
    }
    30. Measure.identifier:versionSpecificIdentifier.system
    Control1..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Fixed Valueurn:ietf:rfc:3986
    32. Measure.identifier:versionSpecificIdentifier.value
    Control1..1
    Must Supporttrue
    34. Measure.identifier:shortName
    Slice NameshortName
    Definition

    The short name for the measure (e.g. CMS104v4).

    ShortShort name
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control1..1
    Must Supporttrue
    36. Measure.identifier:shortName.use
    Control1..1
    Typecode
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Fixed Valueusual
    38. Measure.identifier:shortName.type
    Control1..1
    TypeCodeableConcept
    Must Supporttrue
    Pattern Value{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
        "code" : "short-name"
      }]
    }
    40. Measure.identifier:shortName.value
    Control1..1
    Must Supporttrue
    42. Measure.identifier:endorserIdentifier
    Slice NameendorserIdentifier
    Definition

    An identifier assigned by the measure endorser.

    ShortEndorser identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    Must Supporttrue
    44. Measure.identifier:endorserIdentifier.use
    Control1..1
    Typecode
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Fixed Valueofficial
    46. Measure.identifier:endorserIdentifier.type
    Control1..1
    TypeCodeableConcept
    Must Supporttrue
    Pattern Value{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
        "code" : "endorser"
      }]
    }
    48. Measure.identifier:endorserIdentifier.system
    Control0..1
    Must Supporttrue
    50. Measure.identifier:endorserIdentifier.value
    Control1..1
    Must Supporttrue
    52. Measure.identifier:endorserIdentifier.assigner
    Control1..1
    Must Supporttrue
    54. Measure.identifier:publisherIdentifier
    Slice NamepublisherIdentifier
    Definition

    An identifier assigned by the measure publisher.

    ShortPublisher identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    Must Supporttrue
    56. Measure.identifier:publisherIdentifier.use
    Control1..1
    Typecode
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Fixed Valueofficial
    58. Measure.identifier:publisherIdentifier.type
    Control1..1
    TypeCodeableConcept
    Must Supporttrue
    Pattern Value{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
        "code" : "publisher"
      }]
    }
    60. Measure.identifier:publisherIdentifier.system
    Control0..1
    Must Supporttrue
    62. Measure.identifier:publisherIdentifier.value
    Control1..1
    Must Supporttrue
    64. Measure.identifier:publisherIdentifier.assigner
    Control1..1
    Must Supporttrue
    66. Measure.title
    Control1..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Requirements

    A published measure must specify a human-friendly title.

    68. Measure.status
    Control1..1
    Typecode
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Requirements

    A published measure must have a status of active.

    Fixed Valueactive
    70. Measure.date
    Control1..1
    TypedateTime
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Requirements

    A published measure must specify the date the measure content was last changed.

    72. Measure.publisher
    Control1..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Requirements

    A published measure must provide publisher information.

    74. Measure.contact
    Control1..*
    TypeContactDetail
    Must Supporttrue
    Requirements

    A published measure must provide contact information for the publisher.

    76. Measure.purpose
    Definition

    Explanation of why this measure is needed and why it has been designed as it has.

    Must Supporttrue
    Requirements

    A published measure should provide a clear description of the purpose of the measure.

    78. Measure.usage
    ShortAllows measure developers to provide additional guidance so that implementers can more easily interpret and implement components of the measure.
    Must Supporttrue
    Requirements

    A published measure should provide clinical usage notes for the measure.

    80. Measure.copyright
    Must Supporttrue
    Requirements

    A published measure should provide copyright information for the measure content.

    82. Measure.approvalDate
    Must Supporttrue
    Requirements

    A published measure must indicate the date the measure content was approved by the publisher.

    84. Measure.lastReviewDate
    Must Supporttrue
    Requirements

    A published measure must indicate when the measure content was last reviewed.

    86. Measure.effectivePeriod
    Must Supporttrue
    Requirements

    A published measure should provide an indication of the period during which the measure content can be effectively applied.

    88. Measure.effectivePeriod.extension:anchor
    Slice Nameanchor
    Control0..1
    TypeExtension(CQFM Effective Period Anchor) (Extension Type: dateTime)
    Must Supporttrue
    90. Measure.effectivePeriod.extension:duration
    Slice Nameduration
    Control0..1
    TypeExtension(CQFM Effective Period Duration) (Extension Type: Duration)
    Must Supporttrue
    92. Measure.topic
    Must Supporttrue
    Requirements

    A published measure should provide relevant topics for the measure content.

    94. Measure.author
    Must Supporttrue
    96. Measure.editor
    Must Supporttrue
    98. Measure.reviewer
    Must Supporttrue
    100. Measure.endorser
    Must Supporttrue
    102. Measure.relatedArtifact
    Must Supporttrue
    Requirements

    A published measure should provide related information such as supporting evidence, citations, and documentation.

    SlicingThis element introduces a set of slices on Measure.relatedArtifact. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • value @ type
    • 104. Measure.relatedArtifact:predecessor
      Slice Namepredecessor
      Definition

      Reference to a predecessor measure that this measure is replacing.

      ShortPrevious measure?
      Control0..1
      Must Supporttrue
      Requirements

      A published measure should indicate which measure it is replacing, if any.

      106. Measure.relatedArtifact:predecessor.type
      Control1..1
      Typecode
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Fixed Valuepredecessor
      108. Measure.relatedArtifact:predecessor.resource
      Control1..1
      Typecanonical(Measure)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      110. Measure.relatedArtifact:citation
      Slice Namecitation
      ShortReference/citation
      Control0..*
      Must Supporttrue
      112. Measure.relatedArtifact:citation.extension:isPrimaryCitation
      Slice NameisPrimaryCitation
      Control0..1
      TypeExtension(Is Primary Citation) (Extension Type: boolean)
      Must Supportfalse
      114. Measure.relatedArtifact:citation.extension:publicationStatus
      Slice NamepublicationStatus
      Control0..1
      TypeExtension(Publication Status) (Extension Type: code)
      Must Supportfalse
      116. Measure.relatedArtifact:citation.extension:publicationDate
      Slice NamepublicationDate
      Control0..1
      TypeExtension(Publication Date) (Extension Type: date)
      Must Supportfalse
      118. Measure.relatedArtifact:citation.type
      Control1..1
      Typecode
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Fixed Valuecitation
      120. Measure.relatedArtifact:derived-from
      Slice Namederived-from
      ShortURL or canonical reference to other resources that a measure is derived from
      Control0..*
      Must Supporttrue
      122. Measure.relatedArtifact:derived-from.type
      Control1..1
      Typecode
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Fixed Valuederived-from
      124. Measure.relatedArtifact:derived-from.label
      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      126. Measure.relatedArtifact:derived-from.display
      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      128. Measure.relatedArtifact:derived-from.url
      ShortShould be permalink otherwise include an "accessed date"
      Control0..1
      Typeurl
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      130. Measure.relatedArtifact:derived-from.resource
      ShortShould be permalink otherwise include an "accessed date"
      Control0..1
      Typecanonical(Measure)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      132. Measure.disclaimer
      Must Supporttrue
      Requirements

      A published measure should provide legal disclaimer relating to the use of the measure content.

      134. Measure.type
      Definition

      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.

      Shortprocess | outcome | structure | patient-reported-outcome | composite
      Control0..*
      BindingUnless not suitable, these codes SHALL be taken from MeasureType
      (extensible to http://terminology.hl7.org/ValueSet/measure-type)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Requirements

      A measure must indicate the type of the measure.

      136. Measure.rationale
      Definition

      Provides a succinct statement of the need for the measure. Usually includes statements pertaining to importance criterion: impact, gap in care, and evidence.

      Must Supportfalse
      138. Measure.definition
      Control0..*
      Must Supportfalse
      140. Measure.definition.extension:definitionTerm
      Slice NamedefinitionTerm
      Control1..1
      TypeExtension(Definition Term) (Complex Extension)
      Must Supportfalse
      142. Measure.guidance
      Control0..0
      Must Supportfalse
      144. Measure.group
      146. Measure.group.extension:improvementNotationGuidance
      Slice NameimprovementNotationGuidance
      Control0..1
      TypeExtension(CQFM Improvement Notation) (Extension Type: CodeableConcept)
      Must Supporttrue

      Guidance on how to interpret the contents of this table can be found here

      0. Measure
      Definition

      The Measure resource provides the definition of a quality measure.

      ShortA quality measure definition
      Control10..1*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: 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 in (%resource.descendants().reference | %resource.descendants().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(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      mea-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
      mea-1: Stratifier SHALL be either a single criteria or a set of criteria components (group.stratifier.all((code | description | criteria).exists() xor component.exists()))
      pmp-0: The tail (meaning everything after the last slash in the URL) of the canonical URL of the Measure resource SHALL match the name of the Measure (url.repeat(substring(indexOf('/')+1,length())).last() = id)
      mea-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
      mea-1: Stratifier SHALL be either a single criteria or a set of criteria components (group.stratifier.all((code | description | criteria).exists() xor component.exists()))
      2. Measure.implicitRules
      Definition

      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.

      ShortA set of rules under which this content was created
      Comments

      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.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      4. Measure.text
      Definition

      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.

      ShortText summary of the resource, for human interpretation
      Comments

      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.

      Control10..1
      TypeNarrative
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      A published measure must provide human-readable narrative description of the measure contents.

      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. Measure.extension:copyrightLabel
      Slice NamecopyrightLabel
      Definition

      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').

      ShortCopyright holder and year(s)
      Comments

      Defines the content expected to be rendered in all representations of the artifact. The (c) symbol should NOT be included in this string. It is expected to be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

      Control0..1
      TypeExtension(Artifact Copyright Label) (Extension Type: string)
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      8. Measure.extension:supplementalDataGuidance
      Slice NamesupplementalDataGuidance
      Definition

      Specifies additional guidance related to the collection and reporting of supplemental data elements defined in the measure.

      ShortSupplemental data guidance
      Control0..*
      TypeExtension(CQFM Supplemental Data Guidance) (Complex Extension)
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      10. Measure.extension:comment
      Slice Namecomment
      Definition

      A comment containing additional documentation, a review comment, usage guidance, or other relevant information from a particular user.

      ShortAdditional documentation, review, or usage guidance
      Control0..*
      TypeExtension(Artifact Comment) (Complex Extension)
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      12. Measure.extension:softwaresystem
      Slice Namesoftwaresystem
      Definition

      Specifies the software systems used in the packaging and testing of measure and library resources. Specifically to know which version of what software was used.

      ShortExtension
      Control0..*
      TypeExtension(CRMI Software System) (Extension Type: Reference(CRMI Software System Device))
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      14. Measure.extension:improvementNotationGuidance
      Slice NameimprovementNotationGuidance
      Definition

      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).

      Shortincrease | decrease
      Control0..1
      TypeExtension(CQFM Improvement Notation) (Extension Type: CodeableConcept)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      16. Measure.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 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).

      ShortExtensions that cannot be ignored
      Comments

      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.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Requirements

      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.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      18. Measure.identifier
      Definition

      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.

      ShortAdditional identifier for the measure
      Comments

      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.

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control30..*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      A published measure must be able to specify additional identifiers such as endorser and publisher identifiers for the measure.


      Allows externally provided and/or usable business identifiers to be easily associated with the module.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on Measure.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • value @ type
      • 20. Measure.identifier:versionIndependentIdentifier
        Slice NameversionIndependentIdentifier
        Definition

        The version-independent globally unique identifier for the measure (GUID).


        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.

        ShortMeasure guidAdditional identifier for the measure
        Comments

        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.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control10..1*
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Allows externally provided and/or usable business identifiers to be easily associated with the module.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. Measure.identifier:versionIndependentIdentifier.use
        Definition

        The purpose of this identifier.

        Shortusual | official | temp | secondary | old (If known)
        Comments

        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

        Control10..1
        BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

        Identifies the purpose for this identifier, if known .

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

        Fixed Valueofficial
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. Measure.identifier:versionIndependentIdentifier.type
        Definition

        A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

        ShortDescription of identifier
        Comments

        This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

        Control10..1
        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type
        (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

        A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Allows users to make use of identifiers when the identifier system is not known.

        Pattern Value{
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code" : "version-independent"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. Measure.identifier:versionIndependentIdentifier.system
        Definition

        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

        ShortThe namespace for the identifier value
        Comments

        Identifier.system is always case sensitive.

        Control10..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

        Fixed Valueurn:ietf:rfc:3986
        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. Measure.identifier:versionIndependentIdentifier.value
        Definition

        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

        ShortThe value that is unique
        Comments

        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Example<br/><b>General</b>:123456
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. Measure.identifier:versionSpecificIdentifier
        Slice NameversionSpecificIdentifier
        Definition

        The version-specific globally unique identifier for the measure (GUID).


        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.

        ShortMeasure version guidAdditional identifier for the measure
        Comments

        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.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control10..1*
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Allows externally provided and/or usable business identifiers to be easily associated with the module.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. Measure.identifier:versionSpecificIdentifier.use
        Definition

        The purpose of this identifier.

        Shortusual | official | temp | secondary | old (If known)
        Comments

        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

        Control10..1
        BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

        Identifies the purpose for this identifier, if known .

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

        Fixed Valueofficial
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. Measure.identifier:versionSpecificIdentifier.type
        Definition

        A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

        ShortDescription of identifier
        Comments

        This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

        Control10..1
        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type
        (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

        A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Allows users to make use of identifiers when the identifier system is not known.

        Pattern Value{
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code" : "version-specific"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. Measure.identifier:versionSpecificIdentifier.system
        Definition

        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

        ShortThe namespace for the identifier value
        Comments

        Identifier.system is always case sensitive.

        Control10..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

        Fixed Valueurn:ietf:rfc:3986
        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. Measure.identifier:versionSpecificIdentifier.value
        Definition

        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

        ShortThe value that is unique
        Comments

        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Example<br/><b>General</b>:123456
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. Measure.identifier:shortName
        Slice NameshortName
        Definition

        The short name for the measure (e.g. CMS104v4).


        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.

        ShortShort nameAdditional identifier for the measure
        Comments

        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.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control10..1*
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Allows externally provided and/or usable business identifiers to be easily associated with the module.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. Measure.identifier:shortName.use
        Definition

        The purpose of this identifier.

        Shortusual | official | temp | secondary | old (If known)
        Comments

        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

        Control10..1
        BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

        Identifies the purpose for this identifier, if known .

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

        Fixed Valueusual
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. Measure.identifier:shortName.type
        Definition

        A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

        ShortDescription of identifier
        Comments

        This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

        Control10..1
        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type
        (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

        A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Allows users to make use of identifiers when the identifier system is not known.

        Pattern Value{
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code" : "short-name"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. Measure.identifier:shortName.value
        Definition

        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

        ShortThe value that is unique
        Comments

        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Example<br/><b>General</b>:123456
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. Measure.identifier:endorserIdentifier
        Slice NameendorserIdentifier
        Definition

        An identifier assigned by the measure endorser.


        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.

        ShortEndorser identifierAdditional identifier for the measure
        Comments

        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.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Allows externally provided and/or usable business identifiers to be easily associated with the module.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. Measure.identifier:endorserIdentifier.use
        Definition

        The purpose of this identifier.

        Shortusual | official | temp | secondary | old (If known)
        Comments

        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

        Control10..1
        BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

        Identifies the purpose for this identifier, if known .

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

        Fixed Valueofficial
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. Measure.identifier:endorserIdentifier.type
        Definition

        A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

        ShortDescription of identifier
        Comments

        This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

        Control10..1
        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type
        (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

        A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Allows users to make use of identifiers when the identifier system is not known.

        Pattern Value{
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code" : "endorser"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. Measure.identifier:endorserIdentifier.system
        Definition

        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

        ShortThe namespace for the identifier value
        Comments

        Identifier.system is always case sensitive.

        Control0..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. Measure.identifier:endorserIdentifier.value
        Definition

        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

        ShortThe value that is unique
        Comments

        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Example<br/><b>General</b>:123456
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. Measure.identifier:endorserIdentifier.assigner
        Definition

        Organization that issued/manages the identifier.

        ShortOrganization that issued id (may be just text)
        Comments

        The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

        Control10..1
        TypeReference(Organization)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. Measure.identifier:publisherIdentifier
        Slice NamepublisherIdentifier
        Definition

        An identifier assigned by the measure publisher.


        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.

        ShortPublisher identifierAdditional identifier for the measure
        Comments

        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.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Allows externally provided and/or usable business identifiers to be easily associated with the module.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. Measure.identifier:publisherIdentifier.use
        Definition

        The purpose of this identifier.

        Shortusual | official | temp | secondary | old (If known)
        Comments

        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

        Control10..1
        BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

        Identifies the purpose for this identifier, if known .

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

        Fixed Valueofficial
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. Measure.identifier:publisherIdentifier.type
        Definition

        A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

        ShortDescription of identifier
        Comments

        This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

        Control10..1
        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type
        (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

        A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Allows users to make use of identifiers when the identifier system is not known.

        Pattern Value{
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code" : "publisher"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. Measure.identifier:publisherIdentifier.system
        Definition

        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

        ShortThe namespace for the identifier value
        Comments

        Identifier.system is always case sensitive.

        Control0..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. Measure.identifier:publisherIdentifier.value
        Definition

        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

        ShortThe value that is unique
        Comments

        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Example<br/><b>General</b>:123456
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. Measure.identifier:publisherIdentifier.assigner
        Definition

        Organization that issued/manages the identifier.

        ShortOrganization that issued id (may be just text)
        Comments

        The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

        Control10..1
        TypeReference(Organization)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. Measure.title
        Definition

        A short, descriptive, user-friendly title for the measure.

        ShortName for this measure (human friendly)
        Comments

        This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        A published measure must specify a human-friendly title.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. Measure.status
        Definition

        The status of this measure. Enables tracking the life-cycle of the content.

        Shortdraft | active | retired | unknown
        Comments

        Allows filtering of measures that are appropriate for use versus not.

        Control1..1
        BindingThe codes SHALL be taken from PublicationStatushttp://hl7.org/fhir/ValueSet/publication-status|4.0.1
        (required to http://hl7.org/fhir/ValueSet/publication-status|4.0.1)

        The lifecycle status of an artifact.

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Requirements

        A published measure must have a status of active.

        Fixed Valueactive
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        76. Measure.date
        Definition

        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.

        ShortDate last changed
        Comments

        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.

        Control10..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        A published measure must specify the date the measure content was last changed.

        Alternate NamesRevision Date
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        78. Measure.publisher
        Definition

        The name of the organization or individual that published the measure.

        ShortName of the publisher (organization or individual)
        Comments

        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.

        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Requirements

        A published measure must provide publisher information.


        Helps establish the "authority/credibility" of the measure. May also allow for contact.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        80. Measure.contact
        Definition

        Contact details to assist a user in finding and communicating with the publisher.

        ShortContact details for the publisher
        Comments

        May be a web site, an email address, a telephone number, etc.

        Control10..*
        TypeContactDetail
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        A published measure must provide contact information for the publisher.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        82. Measure.useContext
        Definition

        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.

        ShortThe context that the content is intended to support
        Comments

        When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

        Control0..*
        TypeUsageContext
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Assist in searching for appropriate content.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        84. Measure.jurisdiction
        Definition

        A legal or geographic region in which the measure is intended to be used.

        ShortIntended jurisdiction for measure (if applicable)
        Comments

        It may be possible for the measure to be used in jurisdictions other than those for which it was originally designed or intended.

        Control0..*
        BindingUnless not suitable, these codes SHALL be taken from Jurisdiction ValueSethttp://hl7.org/fhir/ValueSet/jurisdiction
        (extensible to http://hl7.org/fhir/ValueSet/jurisdiction)

        Countries and regions within which this artifact is targeted for use.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        86. Measure.purpose
        Definition

        Explanation of why this measure is needed and why it has been designed as it has.

        ShortWhy this measure is defined
        Comments

        This element does not describe the usage of the measure. Instead, it provides traceability 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.

        Control0..1
        Typemarkdown
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summaryfalse
        Requirements

        A published measure should provide a clear description of the purpose of the measure.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        88. Measure.usage
        Definition

        A detailed description, from a clinical perspective, of how the measure is used.

        ShortAllows measure developers to provide additional guidance so that implementers can more easily interpret and implement components of the measure.Describes the clinical usage of the measure
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summaryfalse
        Requirements

        A published measure should provide clinical usage notes for the measure.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        90. Measure.copyright
        Definition

        A copyright statement relating to the measure and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the measure.

        ShortUse and/or publishing restrictions
        Control0..1
        Typemarkdown
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summaryfalse
        Requirements

        A published measure should provide copyright information for the measure content.


        Consumers must be able to determine any legal restrictions on the use of the measure and/or its content.

        Alternate NamesLicense, Restrictions
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        92. Measure.approvalDate
        Definition

        The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

        ShortWhen the measure was approved by publisher
        Comments

        The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

        Control0..1
        Typedate
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summaryfalse
        Requirements

        A published measure must indicate the date the measure content was approved by the publisher.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        94. Measure.lastReviewDate
        Definition

        The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

        ShortWhen the measure was last reviewed
        Comments

        If specified, this date follows the original approval date.

        Control0..1
        Typedate
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summaryfalse
        Requirements

        A published measure must indicate when the measure content was last reviewed.


        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.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        96. Measure.effectivePeriod
        Definition

        The period during which the measure content was or is planned to be in active use.

        ShortWhen the measure is expected to be used
        Comments

        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.

        Control0..1
        TypePeriod
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        A published measure should provide an indication of the period during which the measure content can be effectively applied.


        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.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        98. Measure.effectivePeriod.extension:anchor
        Slice Nameanchor
        Definition

        Specifies the anchor date for the effective period as defined by a starting date and a range.

        ShortDate of first effective use
        Control0..1
        TypeExtension(CQFM Effective Period Anchor) (Extension Type: dateTime)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        100. Measure.effectivePeriod.extension:duration
        Slice Nameduration
        Definition

        Specifies the reporting period for the measure.

        ShortWhat reporting period is used
        Control0..1
        TypeExtension(CQFM Effective Period Duration) (Extension Type: Duration)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        102. Measure.topic
        Definition

        Descriptive topics related to the content of the measure. Topics provide a high-level categorization grouping types of measures that can be useful for filtering and searching.

        ShortThe category of the measure, such as Education, Treatment, Assessment, etc.
        Control0..*
        BindingFor example codes, see DefinitionTopichttp://hl7.org/fhir/ValueSet/definition-topic
        (example to http://hl7.org/fhir/ValueSet/definition-topic)

        High-level categorization of the definition, used for searching, sorting, and filtering.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

        A published measure should provide relevant topics for the measure content.


        Repositories must be able to determine how to categorize the measure so that it can be found by topical searches.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        104. Measure.author
        Definition

        An individiual or organization primarily involved in the creation and maintenance of the content.

        ShortWho authored the content
        Control0..*
        TypeContactDetail
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        106. Measure.editor
        Definition

        An individual or organization primarily responsible for internal coherence of the content.

        ShortWho edited the content
        Control0..*
        TypeContactDetail
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        108. Measure.reviewer
        Definition

        An individual or organization primarily responsible for review of some aspect of the content.

        ShortWho reviewed the content
        Control0..*
        TypeContactDetail
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        110. Measure.endorser
        Definition

        An individual or organization responsible for officially endorsing the content for use in some setting.

        ShortWho endorsed the content
        Control0..*
        TypeContactDetail
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        112. Measure.relatedArtifact
        Definition

        Related artifacts such as additional documentation, justification, or bibliographic references.

        ShortAdditional documentation, citations, etc.
        Comments

        Each related artifact is either an attachment, or a reference to another resource, but not both.

        Control0..*
        TypeRelatedArtifact
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

        A published measure should provide related information such as supporting evidence, citations, and documentation.


        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.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on Measure.relatedArtifact. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • value @ type
        • 114. Measure.relatedArtifact.type
          Definition

          The type of relationship to the related artifact.

          Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
          Control1..1
          BindingThe codes SHALL be taken from RelatedArtifactTypehttp://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1
          (required to http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1)

          The type of relationship to the related artifact.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          116. Measure.relatedArtifact.display
          Definition

          A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

          ShortBrief description of the related artifact
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          118. Measure.relatedArtifact.document
          Definition

          The document being referenced, represented as an attachment. This is exclusive with the resource element.

          ShortWhat document is being referenced
          Control0..1
          TypeAttachment
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          120. Measure.relatedArtifact.resource
          Definition

          The related resource, such as a library, value set, profile, or other knowledge resource.

          ShortWhat resource is being referenced
          Comments

          If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

          Control0..1
          Typecanonical(Resource)
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          122. Measure.relatedArtifact:predecessor
          Slice Namepredecessor
          Definition

          Reference to a predecessor measure that this measure is replacing.


          Related artifacts such as additional documentation, justification, or bibliographic references.

          ShortPrevious measure?Additional documentation, citations, etc.
          Comments

          Each related artifact is either an attachment, or a reference to another resource, but not both.

          Control0..1*
          TypeRelatedArtifact
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          A published measure should indicate which measure it is replacing, if any.


          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.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          124. Measure.relatedArtifact:predecessor.type
          Definition

          The type of relationship to the related artifact.

          Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
          Control1..1
          BindingThe codes SHALL be taken from RelatedArtifactTypehttp://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1
          (required to http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1)

          The type of relationship to the related artifact.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Fixed Valuepredecessor
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          126. Measure.relatedArtifact:predecessor.display
          Definition

          A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

          ShortBrief description of the related artifact
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          128. Measure.relatedArtifact:predecessor.document
          Definition

          The document being referenced, represented as an attachment. This is exclusive with the resource element.

          ShortWhat document is being referenced
          Control0..1
          TypeAttachment
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          130. Measure.relatedArtifact:predecessor.resource
          Definition

          The related resource, such as a library, value set, profile, or other knowledge resource.

          ShortWhat resource is being referenced
          Comments

          If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

          Control10..1
          Typecanonical(Measure, Resource)
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          132. Measure.relatedArtifact:citation
          Slice Namecitation
          Definition

          Related artifacts such as additional documentation, justification, or bibliographic references.

          ShortReference/citationAdditional documentation, citations, etc.
          Comments

          Each related artifact is either an attachment, or a reference to another resource, but not both.

          Control0..*
          TypeRelatedArtifact
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          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.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          134. Measure.relatedArtifact:citation.extension:isPrimaryCitation
          Slice NameisPrimaryCitation
          Definition

          Specifies whether the related artifact is defining a primary citation for the artifact (i.e. one that should appear in the narrative for the artifact specification.

          ShortPrimary reference
          Control0..1
          TypeExtension(Is Primary Citation) (Extension Type: boolean)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          136. Measure.relatedArtifact:citation.extension:publicationStatus
          Slice NamepublicationStatus
          Definition

          Specifies the publication status of the referenced artifacts.

          ShortPublication status of referenced artifact
          Control0..1
          TypeExtension(Publication Status) (Extension Type: code)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          138. Measure.relatedArtifact:citation.extension:publicationDate
          Slice NamepublicationDate
          Definition

          Specifies the publication date of the referenced artifacts.

          ShortPublication date of referenced artifact
          Control0..1
          TypeExtension(Publication Date) (Extension Type: date)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          140. Measure.relatedArtifact:citation.type
          Definition

          The type of relationship to the related artifact.

          Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
          Control1..1
          BindingThe codes SHALL be taken from RelatedArtifactTypehttp://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1
          (required to http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1)

          The type of relationship to the related artifact.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Fixed Valuecitation
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          142. Measure.relatedArtifact:citation.display
          Definition

          A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

          ShortBrief description of the related artifact
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          144. Measure.relatedArtifact:citation.document
          Definition

          The document being referenced, represented as an attachment. This is exclusive with the resource element.

          ShortWhat document is being referenced
          Control0..1
          TypeAttachment
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          146. Measure.relatedArtifact:citation.resource
          Definition

          The related resource, such as a library, value set, profile, or other knowledge resource.

          ShortWhat resource is being referenced
          Comments

          If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

          Control0..1
          Typecanonical(Resource)
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          148. Measure.relatedArtifact:derived-from
          Slice Namederived-from
          Definition

          Related artifacts such as additional documentation, justification, or bibliographic references.

          ShortURL or canonical reference to other resources that a measure is derived fromAdditional documentation, citations, etc.
          Comments

          Each related artifact is either an attachment, or a reference to another resource, but not both.

          Control0..*
          TypeRelatedArtifact
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          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.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          150. Measure.relatedArtifact:derived-from.type
          Definition

          The type of relationship to the related artifact.

          Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
          Control1..1
          BindingThe codes SHALL be taken from RelatedArtifactTypehttp://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1
          (required to http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1)

          The type of relationship to the related artifact.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Fixed Valuederived-from
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          152. Measure.relatedArtifact:derived-from.label
          Definition

          A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.

          ShortShort label
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          154. Measure.relatedArtifact:derived-from.display
          Definition

          A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

          ShortBrief description of the related artifact
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          156. Measure.relatedArtifact:derived-from.url
          Definition

          A url for the artifact that can be followed to access the actual content.

          ShortShould be permalink otherwise include an "accessed date"Where the artifact can be accessed
          Comments

          If a document or resource element is present, this element SHALL NOT be provided (use the url or reference in the Attachment or resource reference).

          Control0..1
          Typeurl
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          158. Measure.relatedArtifact:derived-from.document
          Definition

          The document being referenced, represented as an attachment. This is exclusive with the resource element.

          ShortWhat document is being referenced
          Control0..1
          TypeAttachment
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          160. Measure.relatedArtifact:derived-from.resource
          Definition

          The related resource, such as a library, value set, profile, or other knowledge resource.

          ShortShould be permalink otherwise include an "accessed date"What resource is being referenced
          Comments

          If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

          Control0..1
          Typecanonical(Measure, Resource)
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          162. Measure.disclaimer
          Definition

          Notices and disclaimers regarding the use of the measure or related to intellectual property (such as code systems) referenced by the measure.

          ShortDisclaimer for use of the measure or its referenced content
          Control0..1
          Typemarkdown
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          A published measure should provide legal disclaimer relating to the use of the measure content.


          Some organizations require that notices and disclosures be included when publishing measures that reference their intellecutal property.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          164. Measure.type
          Definition

          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.

          Shortprocess | outcome | structure | patient-reported-outcome | composite
          Control0..*
          BindingUnless not suitable, these codes SHALL be taken from MeasureTypehttp://hl7.org/fhir/ValueSet/measure-type
          (extensible to http://terminology.hl7.org/ValueSet/measure-type)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          A measure must indicate the type of the measure.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          166. Measure.rationale
          Definition

          Provides a succinct statement of the need for the measure. Usually includes statements pertaining to importance criterion: impact, gap in care, and evidence.

          ShortDetailed description of why the measure exists
          Control0..1
          Typemarkdown
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summarytrue
          Requirements

          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.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          168. Measure.definition
          Definition

          Provides a description of an individual term used within the measure.

          ShortDefined terms used in the measure documentation
          Control0..*
          Typemarkdown
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summarytrue
          Requirements

          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.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          170. Measure.definition.extension
          Definition

          An Extension


          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 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.

          ShortExtensionAdditional content defined by implementations
          Comments

          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.

          Control10..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Measure.definition.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 172. Measure.definition.extension:definitionTerm
            Slice NamedefinitionTerm
            Definition

            Specifies a term and its associated definition.

            ShortDefined term
            Control1..1
            TypeExtension(Definition Term) (Complex Extension)
            Is Modifierfalse
            Must Supportfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            174. Measure.guidance
            Definition

            Additional guidance for the measure including how it can be used in a clinical context, and the intent of the measure.

            ShortAdditional guidance for implementers
            Control0..01
            Typemarkdown
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summarytrue
            Requirements

            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.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            176. Measure.group
            Definition

            A group of population criteria for the measure.

            ShortPopulation criteria group
            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            178. Measure.group.extension:improvementNotationGuidance
            Slice NameimprovementNotationGuidance
            Definition

            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).

            Shortincrease | decrease
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(CQFM Improvement Notation) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            180. Measure.group.modifierExtension
            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 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).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            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.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())

            Guidance on how to interpret the contents of this table can be found here

            0. Measure
            Definition

            The Measure resource provides the definition of a quality measure.

            ShortA quality measure definition
            Control1..1
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
            dom-3: 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 in (%resource.descendants().reference | %resource.descendants().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(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
            dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
            dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
            dom-6: A resource should have narrative for robust management (text.`div`.exists())
            mea-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
            mea-1: Stratifier SHALL be either a single criteria or a set of criteria components (group.stratifier.all((code | description | criteria).exists() xor component.exists()))
            pmp-0: The tail (meaning everything after the last slash in the URL) of the canonical URL of the Measure resource SHALL match the name of the Measure (url.repeat(substring(indexOf('/')+1,length())).last() = id)
            2. Measure.id
            Definition

            The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

            ShortLogical id of this artifact
            Comments

            The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

            Control0..1
            Typeid
            Is Modifierfalse
            Summarytrue
            4. Measure.meta
            Definition

            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.

            ShortMetadata about the resource
            Control0..1
            TypeMeta
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            6. Measure.implicitRules
            Definition

            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.

            ShortA set of rules under which this content was created
            Comments

            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.

            Control0..1
            Typeuri
            Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            8. Measure.language
            Definition

            The base language in which the resource is written.

            ShortLanguage of the resource content
            Comments

            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).

            Control0..1
            BindingThe codes SHOULD be taken from CommonLanguages
            (preferred to http://hl7.org/fhir/ValueSet/languages)

            A human language.

            Additional BindingsPurpose
            AllLanguagesMax Binding
            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            10. Measure.text
            Definition

            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.

            ShortText summary of the resource, for human interpretation
            Comments

            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.

            Control1..1
            TypeNarrative
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            A published measure must provide human-readable narrative description of the measure contents.

            Alternate Namesnarrative, html, xhtml, display
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            12. Measure.contained
            Definition

            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.

            ShortContained, inline Resources
            Comments

            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.

            Control0..*
            TypeResource
            Is Modifierfalse
            Summaryfalse
            Alternate Namesinline resources, anonymous resources, contained resources
            14. Measure.extension
            Definition

            An Extension

            ShortExtension
            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Measure.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 16. Measure.extension:copyrightLabel
              Slice NamecopyrightLabel
              Definition

              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').

              ShortCopyright holder and year(s)
              Comments

              Defines the content expected to be rendered in all representations of the artifact. The (c) symbol should NOT be included in this string. It is expected to be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

              Control0..1
              TypeExtension(Artifact Copyright Label) (Extension Type: string)
              Is Modifierfalse
              Must Supporttrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              18. Measure.extension:supplementalDataGuidance
              Slice NamesupplementalDataGuidance
              Definition

              Specifies additional guidance related to the collection and reporting of supplemental data elements defined in the measure.

              ShortSupplemental data guidance
              Control0..*
              TypeExtension(CQFM Supplemental Data Guidance) (Complex Extension)
              Is Modifierfalse
              Must Supporttrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              20. Measure.extension:comment
              Slice Namecomment
              Definition

              A comment containing additional documentation, a review comment, usage guidance, or other relevant information from a particular user.

              ShortAdditional documentation, review, or usage guidance
              Control0..*
              TypeExtension(Artifact Comment) (Complex Extension)
              Is Modifierfalse
              Must Supporttrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              22. Measure.extension:softwaresystem
              Slice Namesoftwaresystem
              Definition

              Specifies the software systems used in the packaging and testing of measure and library resources. Specifically to know which version of what software was used.

              ShortExtension
              Control0..*
              TypeExtension(CRMI Software System) (Extension Type: Reference(CRMI Software System Device))
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              24. Measure.extension:improvementNotationGuidance
              Slice NameimprovementNotationGuidance
              Definition

              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).

              Shortincrease | decrease
              Control0..1
              TypeExtension(CQFM Improvement Notation) (Extension Type: CodeableConcept)
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              26. Measure.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 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).

              ShortExtensions that cannot be ignored
              Comments

              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.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
              Summaryfalse
              Requirements

              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.

              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              28. Measure.url
              Definition

              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.

              ShortCanonical identifier for this measure, represented as a URI (globally unique)
              Comments

              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.

              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 element to indicate where the current master source of the resource can be found.

              Control0..1
              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Allows the measure to be referenced by a single globally unique identifier.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              30. Measure.identifier
              Definition

              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.

              ShortAdditional identifier for the measure
              Comments

              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.

              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control3..*
              TypeIdentifier
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

              A published measure must be able to specify additional identifiers such as endorser and publisher identifiers for the measure.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on Measure.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ type
              • 32. Measure.identifier:versionIndependentIdentifier
                Slice NameversionIndependentIdentifier
                Definition

                The version-independent globally unique identifier for the measure (GUID).

                ShortMeasure guid
                Comments

                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.

                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control1..1
                TypeIdentifier
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Requirements

                Allows externally provided and/or usable business identifiers to be easily associated with the module.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                34. Measure.identifier:versionIndependentIdentifier.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                36. Measure.identifier:versionIndependentIdentifier.extension
                Definition

                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 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.

                ShortAdditional content defined by implementations
                Comments

                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.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on Measure.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 38. Measure.identifier:versionIndependentIdentifier.use
                  Definition

                  The purpose of this identifier.

                  Shortusual | official | temp | secondary | old (If known)
                  Comments

                  Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                  Control1..1
                  BindingThe codes SHALL be taken from IdentifierUse
                  (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                  Identifies the purpose for this identifier, if known .

                  Typecode
                  Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                  Fixed Valueofficial
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  40. Measure.identifier:versionIndependentIdentifier.type
                  Definition

                  A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                  ShortDescription of identifier
                  Comments

                  This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                  Control1..1
                  BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                  (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                  A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Allows users to make use of identifiers when the identifier system is not known.

                  Pattern Value{
                    "coding" : [{
                      "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
                      "code" : "version-independent"
                    }]
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  42. Measure.identifier:versionIndependentIdentifier.system
                  Definition

                  Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                  ShortThe namespace for the identifier value
                  Comments

                  Identifier.system is always case sensitive.

                  Control1..1
                  Typeuri
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                  Fixed Valueurn:ietf:rfc:3986
                  Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  44. Measure.identifier:versionIndependentIdentifier.value
                  Definition

                  The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                  ShortThe value that is unique
                  Comments

                  If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                  Control1..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Example<br/><b>General</b>:123456
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  46. Measure.identifier:versionIndependentIdentifier.period
                  Definition

                  Time period during which identifier is/was valid for use.

                  ShortTime period when id is/was valid for use
                  Control0..1
                  TypePeriod
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  48. Measure.identifier:versionIndependentIdentifier.assigner
                  Definition

                  Organization that issued/manages the identifier.

                  ShortOrganization that issued id (may be just text)
                  Comments

                  The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                  Control0..1
                  TypeReference(Organization)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  50. Measure.identifier:versionSpecificIdentifier
                  Slice NameversionSpecificIdentifier
                  Definition

                  The version-specific globally unique identifier for the measure (GUID).

                  ShortMeasure version guid
                  Comments

                  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.

                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control1..1
                  TypeIdentifier
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Allows externally provided and/or usable business identifiers to be easily associated with the module.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  52. Measure.identifier:versionSpecificIdentifier.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  54. Measure.identifier:versionSpecificIdentifier.extension
                  Definition

                  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 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.

                  ShortAdditional content defined by implementations
                  Comments

                  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.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on Measure.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 56. Measure.identifier:versionSpecificIdentifier.use
                    Definition

                    The purpose of this identifier.

                    Shortusual | official | temp | secondary | old (If known)
                    Comments

                    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                    Control1..1
                    BindingThe codes SHALL be taken from IdentifierUse
                    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                    Identifies the purpose for this identifier, if known .

                    Typecode
                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                    Fixed Valueofficial
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    58. Measure.identifier:versionSpecificIdentifier.type
                    Definition

                    A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                    ShortDescription of identifier
                    Comments

                    This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                    Control1..1
                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                    A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Allows users to make use of identifiers when the identifier system is not known.

                    Pattern Value{
                      "coding" : [{
                        "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
                        "code" : "version-specific"
                      }]
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    60. Measure.identifier:versionSpecificIdentifier.system
                    Definition

                    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                    ShortThe namespace for the identifier value
                    Comments

                    Identifier.system is always case sensitive.

                    Control1..1
                    Typeuri
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                    Fixed Valueurn:ietf:rfc:3986
                    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    62. Measure.identifier:versionSpecificIdentifier.value
                    Definition

                    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                    ShortThe value that is unique
                    Comments

                    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                    Control1..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Example<br/><b>General</b>:123456
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    64. Measure.identifier:versionSpecificIdentifier.period
                    Definition

                    Time period during which identifier is/was valid for use.

                    ShortTime period when id is/was valid for use
                    Control0..1
                    TypePeriod
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    66. Measure.identifier:versionSpecificIdentifier.assigner
                    Definition

                    Organization that issued/manages the identifier.

                    ShortOrganization that issued id (may be just text)
                    Comments

                    The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                    Control0..1
                    TypeReference(Organization)
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    68. Measure.identifier:shortName
                    Slice NameshortName
                    Definition

                    The short name for the measure (e.g. CMS104v4).

                    ShortShort name
                    Comments

                    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.

                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control1..1
                    TypeIdentifier
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Allows externally provided and/or usable business identifiers to be easily associated with the module.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    70. Measure.identifier:shortName.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    72. Measure.identifier:shortName.extension
                    Definition

                    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 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.

                    ShortAdditional content defined by implementations
                    Comments

                    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.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on Measure.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 74. Measure.identifier:shortName.use
                      Definition

                      The purpose of this identifier.

                      Shortusual | official | temp | secondary | old (If known)
                      Comments

                      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                      Control1..1
                      BindingThe codes SHALL be taken from IdentifierUse
                      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                      Identifies the purpose for this identifier, if known .

                      Typecode
                      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                      Fixed Valueusual
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      76. Measure.identifier:shortName.type
                      Definition

                      A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                      ShortDescription of identifier
                      Comments

                      This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                      Control1..1
                      BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                      (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                      A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      Allows users to make use of identifiers when the identifier system is not known.

                      Pattern Value{
                        "coding" : [{
                          "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
                          "code" : "short-name"
                        }]
                      }
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      78. Measure.identifier:shortName.system
                      Definition

                      Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                      ShortThe namespace for the identifier value
                      Comments

                      Identifier.system is always case sensitive.

                      Control0..1
                      Typeuri
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                      Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      80. Measure.identifier:shortName.value
                      Definition

                      The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                      ShortThe value that is unique
                      Comments

                      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                      Control1..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summarytrue
                      Example<br/><b>General</b>:123456
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      82. Measure.identifier:shortName.period
                      Definition

                      Time period during which identifier is/was valid for use.

                      ShortTime period when id is/was valid for use
                      Control0..1
                      TypePeriod
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      84. Measure.identifier:shortName.assigner
                      Definition

                      Organization that issued/manages the identifier.

                      ShortOrganization that issued id (may be just text)
                      Comments

                      The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                      Control0..1
                      TypeReference(Organization)
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      86. Measure.identifier:endorserIdentifier
                      Slice NameendorserIdentifier
                      Definition

                      An identifier assigned by the measure endorser.

                      ShortEndorser identifier
                      Comments

                      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.

                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control0..*
                      TypeIdentifier
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      Allows externally provided and/or usable business identifiers to be easily associated with the module.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      88. Measure.identifier:endorserIdentifier.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      90. Measure.identifier:endorserIdentifier.extension
                      Definition

                      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 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.

                      ShortAdditional content defined by implementations
                      Comments

                      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.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on Measure.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 92. Measure.identifier:endorserIdentifier.use
                        Definition

                        The purpose of this identifier.

                        Shortusual | official | temp | secondary | old (If known)
                        Comments

                        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                        Control1..1
                        BindingThe codes SHALL be taken from IdentifierUse
                        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                        Identifies the purpose for this identifier, if known .

                        Typecode
                        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                        Fixed Valueofficial
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        94. Measure.identifier:endorserIdentifier.type
                        Definition

                        A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                        ShortDescription of identifier
                        Comments

                        This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                        Control1..1
                        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                        (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                        A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        Allows users to make use of identifiers when the identifier system is not known.

                        Pattern Value{
                          "coding" : [{
                            "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
                            "code" : "endorser"
                          }]
                        }
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        96. Measure.identifier:endorserIdentifier.system
                        Definition

                        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                        ShortThe namespace for the identifier value
                        Comments

                        Identifier.system is always case sensitive.

                        Control0..1
                        Typeuri
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        98. Measure.identifier:endorserIdentifier.value
                        Definition

                        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                        ShortThe value that is unique
                        Comments

                        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                        Control1..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Example<br/><b>General</b>:123456
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        100. Measure.identifier:endorserIdentifier.period
                        Definition

                        Time period during which identifier is/was valid for use.

                        ShortTime period when id is/was valid for use
                        Control0..1
                        TypePeriod
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        102. Measure.identifier:endorserIdentifier.assigner
                        Definition

                        Organization that issued/manages the identifier.

                        ShortOrganization that issued id (may be just text)
                        Comments

                        The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                        Control1..1
                        TypeReference(Organization)
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        104. Measure.identifier:publisherIdentifier
                        Slice NamepublisherIdentifier
                        Definition

                        An identifier assigned by the measure publisher.

                        ShortPublisher identifier
                        Comments

                        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.

                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control0..*
                        TypeIdentifier
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        Allows externally provided and/or usable business identifiers to be easily associated with the module.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        106. Measure.identifier:publisherIdentifier.id
                        Definition

                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        ShortUnique id for inter-element referencing
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        108. Measure.identifier:publisherIdentifier.extension
                        Definition

                        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 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.

                        ShortAdditional content defined by implementations
                        Comments

                        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.

                        Control0..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingThis element introduces a set of slices on Measure.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 110. Measure.identifier:publisherIdentifier.use
                          Definition

                          The purpose of this identifier.

                          Shortusual | official | temp | secondary | old (If known)
                          Comments

                          Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                          Control1..1
                          BindingThe codes SHALL be taken from IdentifierUse
                          (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                          Identifies the purpose for this identifier, if known .

                          Typecode
                          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                          Fixed Valueofficial
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          112. Measure.identifier:publisherIdentifier.type
                          Definition

                          A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                          ShortDescription of identifier
                          Comments

                          This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                          Control1..1
                          BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                          (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                          A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Allows users to make use of identifiers when the identifier system is not known.

                          Pattern Value{
                            "coding" : [{
                              "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
                              "code" : "publisher"
                            }]
                          }
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          114. Measure.identifier:publisherIdentifier.system
                          Definition

                          Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                          ShortThe namespace for the identifier value
                          Comments

                          Identifier.system is always case sensitive.

                          Control0..1
                          Typeuri
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                          Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          116. Measure.identifier:publisherIdentifier.value
                          Definition

                          The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                          ShortThe value that is unique
                          Comments

                          If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                          Control1..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Example<br/><b>General</b>:123456
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          118. Measure.identifier:publisherIdentifier.period
                          Definition

                          Time period during which identifier is/was valid for use.

                          ShortTime period when id is/was valid for use
                          Control0..1
                          TypePeriod
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          120. Measure.identifier:publisherIdentifier.assigner
                          Definition

                          Organization that issued/manages the identifier.

                          ShortOrganization that issued id (may be just text)
                          Comments

                          The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                          Control1..1
                          TypeReference(Organization)
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          122. Measure.version
                          Definition

                          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.

                          ShortBusiness version of the measure
                          Comments

                          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].

                          NoteThis is a business versionId, not a resource version id (see discussion)
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          124. Measure.name
                          Definition

                          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.

                          ShortName for this measure (computer friendly)
                          Comments

                          The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

                          Control0..1
                          This element is affected by the following invariants: inv-0
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Support human navigation and code generation.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          126. Measure.title
                          Definition

                          A short, descriptive, user-friendly title for the measure.

                          ShortName for this measure (human friendly)
                          Comments

                          This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

                          Control1..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          A published measure must specify a human-friendly title.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          128. Measure.subtitle
                          Definition

                          An explanatory or alternate title for the measure giving additional information about its content.

                          ShortSubordinate title of the measure
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          130. Measure.status
                          Definition

                          The status of this measure. Enables tracking the life-cycle of the content.

                          Shortdraft | active | retired | unknown
                          Comments

                          Allows filtering of measures that are appropriate for use versus not.

                          Control1..1
                          BindingThe codes SHALL be taken from PublicationStatus
                          (required to http://hl7.org/fhir/ValueSet/publication-status|4.0.1)

                          The lifecycle status of an artifact.

                          Typecode
                          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supportfalse
                          Summarytrue
                          Requirements

                          A published measure must have a status of active.

                          Fixed Valueactive
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          132. Measure.experimental
                          Definition

                          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.

                          ShortFor testing purposes, not real usage
                          Comments

                          Allows filtering of measures that are appropriate for use versus not.

                          Control0..1
                          Typeboolean
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Enables experimental content to be developed following the same lifecycle that would be used for a production-level measure.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          134. Measure.subject[x]
                          Definition

                          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.

                          ShortE.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
                          Comments

                          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.

                          Control0..1
                          BindingUnless not suitable, these codes SHALL be taken from SubjectType
                          (extensible to http://hl7.org/fhir/ValueSet/subject-type)

                          The possible types of subjects for a measure (E.g. Patient, Practitioner, Organization, Location, etc.).

                          TypeChoice of: CodeableConcept, Reference(Group)
                          [x] NoteSee Choice of Data Types for further information about how to use [x]
                          Is Modifierfalse
                          Summaryfalse
                          Meaning if MissingPatient
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          136. Measure.date
                          Definition

                          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.

                          ShortDate last changed
                          Comments

                          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.

                          Control1..1
                          TypedateTime
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          A published measure must specify the date the measure content was last changed.

                          Alternate NamesRevision Date
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          138. Measure.publisher
                          Definition

                          The name of the organization or individual that published the measure.

                          ShortName of the publisher (organization or individual)
                          Comments

                          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.

                          Control1..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supportfalse
                          Summarytrue
                          Requirements

                          A published measure must provide publisher information.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          140. Measure.contact
                          Definition

                          Contact details to assist a user in finding and communicating with the publisher.

                          ShortContact details for the publisher
                          Comments

                          May be a web site, an email address, a telephone number, etc.

                          Control1..*
                          TypeContactDetail
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          A published measure must provide contact information for the publisher.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          142. Measure.description
                          Definition

                          A free text natural language description of the measure from a consumer's perspective.

                          ShortNatural language description of the measure
                          Comments

                          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).

                          Control0..1
                          Typemarkdown
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          144. Measure.useContext
                          Definition

                          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.

                          ShortThe context that the content is intended to support
                          Comments

                          When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

                          Control0..*
                          TypeUsageContext
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Assist in searching for appropriate content.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          146. Measure.jurisdiction
                          Definition

                          A legal or geographic region in which the measure is intended to be used.

                          ShortIntended jurisdiction for measure (if applicable)
                          Comments

                          It may be possible for the measure to be used in jurisdictions other than those for which it was originally designed or intended.

                          Control0..*
                          BindingUnless not suitable, these codes SHALL be taken from Jurisdiction ValueSet
                          (extensible to http://hl7.org/fhir/ValueSet/jurisdiction)

                          Countries and regions within which this artifact is targeted for use.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          148. Measure.purpose
                          Definition

                          Explanation of why this measure is needed and why it has been designed as it has.

                          ShortWhy this measure is defined
                          Comments

                          This element does not describe the usage of the measure. Instead, it provides traceability 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.

                          Control0..1
                          Typemarkdown
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summaryfalse
                          Requirements

                          A published measure should provide a clear description of the purpose of the measure.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          150. Measure.usage
                          Definition

                          A detailed description, from a clinical perspective, of how the measure is used.

                          ShortAllows measure developers to provide additional guidance so that implementers can more easily interpret and implement components of the measure.
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summaryfalse
                          Requirements

                          A published measure should provide clinical usage notes for the measure.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          152. Measure.copyright
                          Definition

                          A copyright statement relating to the measure and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the measure.

                          ShortUse and/or publishing restrictions
                          Control0..1
                          Typemarkdown
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summaryfalse
                          Requirements

                          A published measure should provide copyright information for the measure content.

                          Alternate NamesLicense, Restrictions
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          154. Measure.approvalDate
                          Definition

                          The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

                          ShortWhen the measure was approved by publisher
                          Comments

                          The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

                          Control0..1
                          Typedate
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summaryfalse
                          Requirements

                          A published measure must indicate the date the measure content was approved by the publisher.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          156. Measure.lastReviewDate
                          Definition

                          The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

                          ShortWhen the measure was last reviewed
                          Comments

                          If specified, this date follows the original approval date.

                          Control0..1
                          Typedate
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summaryfalse
                          Requirements

                          A published measure must indicate when the measure content was last reviewed.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          158. Measure.effectivePeriod
                          Definition

                          The period during which the measure content was or is planned to be in active use.

                          ShortWhen the measure is expected to be used
                          Comments

                          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.

                          Control0..1
                          TypePeriod
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          A published measure should provide an indication of the period during which the measure content can be effectively applied.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          160. Measure.effectivePeriod.id
                          Definition

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          162. Measure.effectivePeriod.extension
                          Definition

                          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 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.

                          ShortAdditional content defined by implementations
                          Comments

                          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.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on Measure.effectivePeriod.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 164. Measure.effectivePeriod.extension:anchor
                            Slice Nameanchor
                            Definition

                            Specifies the anchor date for the effective period as defined by a starting date and a range.

                            ShortDate of first effective use
                            Control0..1
                            TypeExtension(CQFM Effective Period Anchor) (Extension Type: dateTime)
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            166. Measure.effectivePeriod.extension:duration
                            Slice Nameduration
                            Definition

                            Specifies the reporting period for the measure.

                            ShortWhat reporting period is used
                            Control0..1
                            TypeExtension(CQFM Effective Period Duration) (Extension Type: Duration)
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            168. Measure.effectivePeriod.start
                            Definition

                            The start of the period. The boundary is inclusive.

                            ShortStarting time with inclusive boundary
                            Comments

                            If the low element is missing, the meaning is that the low boundary is not known.

                            Control0..1
                            This element is affected by the following invariants: per-1
                            TypedateTime
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            170. Measure.effectivePeriod.end
                            Definition

                            The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                            ShortEnd time with inclusive boundary, if not ongoing
                            Comments

                            The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                            Control0..1
                            This element is affected by the following invariants: per-1
                            TypedateTime
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            172. Measure.topic
                            Definition

                            Descriptive topics related to the content of the measure. Topics provide a high-level categorization grouping types of measures that can be useful for filtering and searching.

                            ShortThe category of the measure, such as Education, Treatment, Assessment, etc.
                            Control0..*
                            BindingFor example codes, see DefinitionTopic
                            (example to http://hl7.org/fhir/ValueSet/definition-topic)

                            High-level categorization of the definition, used for searching, sorting, and filtering.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Requirements

                            A published measure should provide relevant topics for the measure content.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            174. Measure.author
                            Definition

                            An individiual or organization primarily involved in the creation and maintenance of the content.

                            ShortWho authored the content
                            Control0..*
                            TypeContactDetail
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            176. Measure.editor
                            Definition

                            An individual or organization primarily responsible for internal coherence of the content.

                            ShortWho edited the content
                            Control0..*
                            TypeContactDetail
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            178. Measure.reviewer
                            Definition

                            An individual or organization primarily responsible for review of some aspect of the content.

                            ShortWho reviewed the content
                            Control0..*
                            TypeContactDetail
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            180. Measure.endorser
                            Definition

                            An individual or organization responsible for officially endorsing the content for use in some setting.

                            ShortWho endorsed the content
                            Control0..*
                            TypeContactDetail
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            182. Measure.relatedArtifact
                            Definition

                            Related artifacts such as additional documentation, justification, or bibliographic references.

                            ShortAdditional documentation, citations, etc.
                            Comments

                            Each related artifact is either an attachment, or a reference to another resource, but not both.

                            Control0..*
                            TypeRelatedArtifact
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Requirements

                            A published measure should provide related information such as supporting evidence, citations, and documentation.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            SlicingThis element introduces a set of slices on Measure.relatedArtifact. The slices are unordered and Open, and can be differentiated using the following discriminators:
                            • value @ type
                            • 184. Measure.relatedArtifact.id
                              Definition

                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              186. Measure.relatedArtifact.extension
                              Definition

                              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 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.

                              ShortAdditional content defined by implementations
                              Comments

                              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.

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on Measure.relatedArtifact.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 188. Measure.relatedArtifact.type
                                Definition

                                The type of relationship to the related artifact.

                                Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
                                Control1..1
                                BindingThe codes SHALL be taken from RelatedArtifactType
                                (required to http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1)

                                The type of relationship to the related artifact.

                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                190. Measure.relatedArtifact.label
                                Definition

                                A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.

                                ShortShort label
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                192. Measure.relatedArtifact.display
                                Definition

                                A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

                                ShortBrief description of the related artifact
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                194. Measure.relatedArtifact.citation
                                Definition

                                A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format.

                                ShortBibliographic citation for the artifact
                                Comments

                                Additional structured information about citations should be captured as extensions.

                                Control0..1
                                Typemarkdown
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                196. Measure.relatedArtifact.url
                                Definition

                                A url for the artifact that can be followed to access the actual content.

                                ShortWhere the artifact can be accessed
                                Comments

                                If a document or resource element is present, this element SHALL NOT be provided (use the url or reference in the Attachment or resource reference).

                                Control0..1
                                Typeurl
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                198. Measure.relatedArtifact.document
                                Definition

                                The document being referenced, represented as an attachment. This is exclusive with the resource element.

                                ShortWhat document is being referenced
                                Control0..1
                                TypeAttachment
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                200. Measure.relatedArtifact.resource
                                Definition

                                The related resource, such as a library, value set, profile, or other knowledge resource.

                                ShortWhat resource is being referenced
                                Comments

                                If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

                                Control0..1
                                Typecanonical(Resource)
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                202. Measure.relatedArtifact:predecessor
                                Slice Namepredecessor
                                Definition

                                Reference to a predecessor measure that this measure is replacing.

                                ShortPrevious measure?
                                Comments

                                Each related artifact is either an attachment, or a reference to another resource, but not both.

                                Control0..1
                                TypeRelatedArtifact
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                Requirements

                                A published measure should indicate which measure it is replacing, if any.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                204. Measure.relatedArtifact:predecessor.id
                                Definition

                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                ShortUnique id for inter-element referencing
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                206. Measure.relatedArtifact:predecessor.extension
                                Definition

                                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 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.

                                ShortAdditional content defined by implementations
                                Comments

                                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.

                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on Measure.relatedArtifact.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 208. Measure.relatedArtifact:predecessor.type
                                  Definition

                                  The type of relationship to the related artifact.

                                  Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
                                  Control1..1
                                  BindingThe codes SHALL be taken from RelatedArtifactType
                                  (required to http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1)

                                  The type of relationship to the related artifact.

                                  Typecode
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Fixed Valuepredecessor
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  210. Measure.relatedArtifact:predecessor.label
                                  Definition

                                  A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.

                                  ShortShort label
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  212. Measure.relatedArtifact:predecessor.display
                                  Definition

                                  A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

                                  ShortBrief description of the related artifact
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  214. Measure.relatedArtifact:predecessor.citation
                                  Definition

                                  A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format.

                                  ShortBibliographic citation for the artifact
                                  Comments

                                  Additional structured information about citations should be captured as extensions.

                                  Control0..1
                                  Typemarkdown
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  216. Measure.relatedArtifact:predecessor.url
                                  Definition

                                  A url for the artifact that can be followed to access the actual content.

                                  ShortWhere the artifact can be accessed
                                  Comments

                                  If a document or resource element is present, this element SHALL NOT be provided (use the url or reference in the Attachment or resource reference).

                                  Control0..1
                                  Typeurl
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  218. Measure.relatedArtifact:predecessor.document
                                  Definition

                                  The document being referenced, represented as an attachment. This is exclusive with the resource element.

                                  ShortWhat document is being referenced
                                  Control0..1
                                  TypeAttachment
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  220. Measure.relatedArtifact:predecessor.resource
                                  Definition

                                  The related resource, such as a library, value set, profile, or other knowledge resource.

                                  ShortWhat resource is being referenced
                                  Comments

                                  If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

                                  Control1..1
                                  Typecanonical(Measure)
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  222. Measure.relatedArtifact:citation
                                  Slice Namecitation
                                  Definition

                                  Related artifacts such as additional documentation, justification, or bibliographic references.

                                  ShortReference/citation
                                  Comments

                                  Each related artifact is either an attachment, or a reference to another resource, but not both.

                                  Control0..*
                                  TypeRelatedArtifact
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Requirements

                                  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.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  224. Measure.relatedArtifact:citation.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  226. Measure.relatedArtifact:citation.extension
                                  Definition

                                  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 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.

                                  ShortAdditional content defined by implementations
                                  Comments

                                  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.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on Measure.relatedArtifact.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 228. Measure.relatedArtifact:citation.extension:isPrimaryCitation
                                    Slice NameisPrimaryCitation
                                    Definition

                                    Specifies whether the related artifact is defining a primary citation for the artifact (i.e. one that should appear in the narrative for the artifact specification.

                                    ShortPrimary reference
                                    Control0..1
                                    TypeExtension(Is Primary Citation) (Extension Type: boolean)
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    230. Measure.relatedArtifact:citation.extension:publicationStatus
                                    Slice NamepublicationStatus
                                    Definition

                                    Specifies the publication status of the referenced artifacts.

                                    ShortPublication status of referenced artifact
                                    Control0..1
                                    TypeExtension(Publication Status) (Extension Type: code)
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    232. Measure.relatedArtifact:citation.extension:publicationDate
                                    Slice NamepublicationDate
                                    Definition

                                    Specifies the publication date of the referenced artifacts.

                                    ShortPublication date of referenced artifact
                                    Control0..1
                                    TypeExtension(Publication Date) (Extension Type: date)
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    234. Measure.relatedArtifact:citation.type
                                    Definition

                                    The type of relationship to the related artifact.

                                    Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
                                    Control1..1
                                    BindingThe codes SHALL be taken from RelatedArtifactType
                                    (required to http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1)

                                    The type of relationship to the related artifact.

                                    Typecode
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summarytrue
                                    Fixed Valuecitation
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    236. Measure.relatedArtifact:citation.label
                                    Definition

                                    A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.

                                    ShortShort label
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    238. Measure.relatedArtifact:citation.display
                                    Definition

                                    A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

                                    ShortBrief description of the related artifact
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    240. Measure.relatedArtifact:citation.citation
                                    Definition

                                    A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format.

                                    ShortBibliographic citation for the artifact
                                    Comments

                                    Additional structured information about citations should be captured as extensions.

                                    Control0..1
                                    Typemarkdown
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    242. Measure.relatedArtifact:citation.url
                                    Definition

                                    A url for the artifact that can be followed to access the actual content.

                                    ShortWhere the artifact can be accessed
                                    Comments

                                    If a document or resource element is present, this element SHALL NOT be provided (use the url or reference in the Attachment or resource reference).

                                    Control0..1
                                    Typeurl
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    244. Measure.relatedArtifact:citation.document
                                    Definition

                                    The document being referenced, represented as an attachment. This is exclusive with the resource element.

                                    ShortWhat document is being referenced
                                    Control0..1
                                    TypeAttachment
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    246. Measure.relatedArtifact:citation.resource
                                    Definition

                                    The related resource, such as a library, value set, profile, or other knowledge resource.

                                    ShortWhat resource is being referenced
                                    Comments

                                    If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

                                    Control0..1
                                    Typecanonical(Resource)
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    248. Measure.relatedArtifact:derived-from
                                    Slice Namederived-from
                                    Definition

                                    Related artifacts such as additional documentation, justification, or bibliographic references.

                                    ShortURL or canonical reference to other resources that a measure is derived from
                                    Comments

                                    Each related artifact is either an attachment, or a reference to another resource, but not both.

                                    Control0..*
                                    TypeRelatedArtifact
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Requirements

                                    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.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    250. Measure.relatedArtifact:derived-from.id
                                    Definition

                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    252. Measure.relatedArtifact:derived-from.extension
                                    Definition

                                    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 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.

                                    ShortAdditional content defined by implementations
                                    Comments

                                    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.

                                    Control0..*
                                    TypeExtension
                                    Is Modifierfalse
                                    Summaryfalse
                                    Alternate Namesextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingThis element introduces a set of slices on Measure.relatedArtifact.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 254. Measure.relatedArtifact:derived-from.type
                                      Definition

                                      The type of relationship to the related artifact.

                                      Shortdocumentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of
                                      Control1..1
                                      BindingThe codes SHALL be taken from RelatedArtifactType
                                      (required to http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1)

                                      The type of relationship to the related artifact.

                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summarytrue
                                      Fixed Valuederived-from
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      256. Measure.relatedArtifact:derived-from.label
                                      Definition

                                      A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.

                                      ShortShort label
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      258. Measure.relatedArtifact:derived-from.display
                                      Definition

                                      A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

                                      ShortBrief description of the related artifact
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      260. Measure.relatedArtifact:derived-from.citation
                                      Definition

                                      A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format.

                                      ShortBibliographic citation for the artifact
                                      Comments

                                      Additional structured information about citations should be captured as extensions.

                                      Control0..1
                                      Typemarkdown
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      262. Measure.relatedArtifact:derived-from.url
                                      Definition

                                      A url for the artifact that can be followed to access the actual content.

                                      ShortShould be permalink otherwise include an "accessed date"
                                      Comments

                                      If a document or resource element is present, this element SHALL NOT be provided (use the url or reference in the Attachment or resource reference).

                                      Control0..1
                                      Typeurl
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      264. Measure.relatedArtifact:derived-from.document
                                      Definition

                                      The document being referenced, represented as an attachment. This is exclusive with the resource element.

                                      ShortWhat document is being referenced
                                      Control0..1
                                      TypeAttachment
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      266. Measure.relatedArtifact:derived-from.resource
                                      Definition

                                      The related resource, such as a library, value set, profile, or other knowledge resource.

                                      ShortShould be permalink otherwise include an "accessed date"
                                      Comments

                                      If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

                                      Control0..1
                                      Typecanonical(Measure)
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      268. Measure.library
                                      Definition

                                      A reference to a Library resource containing the formal logic used by the measure.

                                      ShortLogic used by the measure
                                      Control0..*
                                      Typecanonical(Library)
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      270. Measure.disclaimer
                                      Definition

                                      Notices and disclaimers regarding the use of the measure or related to intellectual property (such as code systems) referenced by the measure.

                                      ShortDisclaimer for use of the measure or its referenced content
                                      Control0..1
                                      Typemarkdown
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

                                      A published measure should provide legal disclaimer relating to the use of the measure content.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      272. Measure.scoring
                                      Definition

                                      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.

                                      Shortproportion | ratio | continuous-variable | cohort
                                      Control0..1
                                      BindingUnless not suitable, these codes SHALL be taken from MeasureScoring
                                      (extensible to http://hl7.org/fhir/ValueSet/measure-scoring)

                                      The scoring type of the measure.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      274. Measure.compositeScoring
                                      Definition

                                      If this is a composite measure, the scoring method used to combine the component measures to determine the composite score.

                                      Shortopportunity | all-or-nothing | linear | weighted
                                      Control0..1
                                      BindingUnless not suitable, these codes SHALL be taken from CompositeMeasureScoring
                                      (extensible to http://hl7.org/fhir/ValueSet/composite-measure-scoring)

                                      The composite scoring method of the measure.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      276. Measure.type
                                      Definition

                                      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.

                                      Shortprocess | outcome | structure | patient-reported-outcome | composite
                                      Control0..*
                                      BindingUnless not suitable, these codes SHALL be taken from MeasureType
                                      (extensible to http://terminology.hl7.org/ValueSet/measure-type)
                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

                                      A measure must indicate the type of the measure.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      278. Measure.riskAdjustment
                                      Definition

                                      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.

                                      ShortHow risk adjustment is applied for this measure
                                      Comments

                                      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.

                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      280. Measure.rateAggregation
                                      Definition

                                      Describes how to combine the information calculated, based on logic in each of several populations, into one summarized result.

                                      ShortHow is rate aggregation performed for this measure
                                      Comments

                                      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).

                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      282. Measure.rationale
                                      Definition

                                      Provides a succinct statement of the need for the measure. Usually includes statements pertaining to importance criterion: impact, gap in care, and evidence.

                                      ShortDetailed description of why the measure exists
                                      Control0..1
                                      Typemarkdown
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summarytrue
                                      Requirements

                                      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.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      284. Measure.clinicalRecommendationStatement
                                      Definition

                                      Provides a summary of relevant clinical guidelines or other clinical recommendations supporting the measure.

                                      ShortSummary of clinical guidelines
                                      Control0..1
                                      Typemarkdown
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      286. Measure.improvementNotation
                                      Definition

                                      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).

                                      Shortincrease | decrease
                                      Control0..1
                                      BindingThe codes SHALL be taken from MeasureImprovementNotation
                                      (required to http://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.1)

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

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      Measure consumers and implementers must be able to determine how to interpret a measure score.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      288. Measure.definition
                                      Definition

                                      Provides a description of an individual term used within the measure.

                                      ShortDefined terms used in the measure documentation
                                      Control0..*
                                      Typemarkdown
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summarytrue
                                      Requirements

                                      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.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      290. Measure.definition.id
                                      Definition

                                      unique id for the element within a resource (for internal references)

                                      Shortxml:id (or equivalent in JSON)
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      292. Measure.definition.extension
                                      Definition

                                      An Extension

                                      ShortExtension
                                      Control1..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingThis element introduces a set of slices on Measure.definition.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 294. Measure.definition.extension:definitionTerm
                                        Slice NamedefinitionTerm
                                        Definition

                                        Specifies a term and its associated definition.

                                        ShortDefined term
                                        Control1..1
                                        TypeExtension(Definition Term) (Complex Extension)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        296. Measure.definition.value
                                        Definition

                                        Primitive value for markdown

                                        ShortPrimitive value for markdown
                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        298. Measure.guidance
                                        Definition

                                        Additional guidance for the measure including how it can be used in a clinical context, and the intent of the measure.

                                        ShortAdditional guidance for implementers
                                        Control0..0
                                        Typemarkdown
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summarytrue
                                        Requirements

                                        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.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        300. Measure.group
                                        Definition

                                        A group of population criteria for the measure.

                                        ShortPopulation criteria group
                                        Control0..*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        302. Measure.group.id
                                        Definition

                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        304. Measure.group.extension
                                        Definition

                                        An Extension

                                        ShortExtension
                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        SlicingThis element introduces a set of slices on Measure.group.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 306. Measure.group.extension:improvementNotationGuidance
                                          Slice NameimprovementNotationGuidance
                                          Definition

                                          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).

                                          Shortincrease | decrease
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension(CQFM Improvement Notation) (Extension Type: CodeableConcept)
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          308. Measure.group.modifierExtension
                                          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 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).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          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.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          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.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          310. Measure.group.code
                                          Definition

                                          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.

                                          ShortMeaning of the group
                                          Control0..1
                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          312. Measure.group.description
                                          Definition

                                          The human readable description of this population group.

                                          ShortSummary description
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          314. Measure.group.population
                                          Definition

                                          A population criteria for the measure.

                                          ShortPopulation criteria
                                          Control0..*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          316. Measure.group.population.id
                                          Definition

                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          318. Measure.group.population.extension
                                          Definition

                                          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 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.

                                          ShortAdditional content defined by implementations
                                          Comments

                                          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.

                                          Control0..*
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          320. Measure.group.population.modifierExtension
                                          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 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).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          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.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          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.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          322. Measure.group.population.code
                                          Definition

                                          The type of population criteria.

                                          Shortinitial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
                                          Control0..1
                                          BindingUnless not suitable, these codes SHALL be taken from MeasurePopulationType
                                          (extensible to http://hl7.org/fhir/ValueSet/measure-population)

                                          The type of population.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          324. Measure.group.population.description
                                          Definition

                                          The human readable description of this population criteria.

                                          ShortThe human readable description of this population criteria
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          326. Measure.group.population.criteria
                                          Definition

                                          An expression that specifies the criteria for the population, typically the name of an expression in a library.

                                          ShortThe criteria that defines this population
                                          Comments

                                          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.

                                          Control1..1
                                          TypeExpression
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          328. Measure.group.stratifier
                                          Definition

                                          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.

                                          ShortStratifier criteria for the measure
                                          Control0..*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          330. Measure.group.stratifier.id
                                          Definition

                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          332. Measure.group.stratifier.extension
                                          Definition

                                          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 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.

                                          ShortAdditional content defined by implementations
                                          Comments

                                          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.

                                          Control0..*
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          334. Measure.group.stratifier.modifierExtension
                                          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 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).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          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.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          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.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          336. Measure.group.stratifier.code
                                          Definition

                                          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.

                                          ShortMeaning of the stratifier
                                          Control0..1
                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          338. Measure.group.stratifier.description
                                          Definition

                                          The human readable description of this stratifier criteria.

                                          ShortThe human readable description of this stratifier
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          340. Measure.group.stratifier.criteria
                                          Definition

                                          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.

                                          ShortHow the measure should be stratified
                                          Control0..1
                                          TypeExpression
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          342. Measure.group.stratifier.component
                                          Definition

                                          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.

                                          ShortStratifier criteria component for the measure
                                          Comments

                                          Stratifiers are defined either as a single criteria, or as a set of component criteria.

                                          Control0..*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          344. Measure.group.stratifier.component.id
                                          Definition

                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          346. Measure.group.stratifier.component.extension
                                          Definition

                                          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 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.

                                          ShortAdditional content defined by implementations
                                          Comments

                                          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.

                                          Control0..*
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          348. Measure.group.stratifier.component.modifierExtension
                                          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 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).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          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.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          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.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          350. Measure.group.stratifier.component.code
                                          Definition

                                          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.

                                          ShortMeaning of the stratifier component
                                          Control0..1
                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          352. Measure.group.stratifier.component.description
                                          Definition

                                          The human readable description of this stratifier criteria component.

                                          ShortThe human readable description of this stratifier component
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          354. Measure.group.stratifier.component.criteria
                                          Definition

                                          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.

                                          ShortComponent of how the measure should be stratified
                                          Control1..1
                                          TypeExpression
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          356. Measure.supplementalData
                                          Definition

                                          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.

                                          ShortWhat other data should be reported with the measure
                                          Comments

                                          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.

                                          Control0..*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          358. Measure.supplementalData.id
                                          Definition

                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          360. Measure.supplementalData.extension
                                          Definition

                                          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 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.

                                          ShortAdditional content defined by implementations
                                          Comments

                                          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.

                                          Control0..*
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          362. Measure.supplementalData.modifierExtension
                                          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 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).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          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.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          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.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          364. Measure.supplementalData.code
                                          Definition

                                          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.

                                          ShortMeaning of the supplemental data
                                          Control0..1
                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          366. Measure.supplementalData.usage
                                          Definition

                                          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.

                                          Shortsupplemental-data | risk-adjustment-factor
                                          Control0..*
                                          BindingUnless not suitable, these codes SHALL be taken from MeasureDataUsage
                                          (extensible to http://hl7.org/fhir/ValueSet/measure-data-usage)

                                          The intended usage for supplemental data elements in the measure.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          368. Measure.supplementalData.description
                                          Definition

                                          The human readable description of this supplemental data.

                                          ShortThe human readable description of this supplemental data
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          370. Measure.supplementalData.criteria
                                          Definition

                                          The criteria for the supplemental data. This is typically the name of a valid expression defined within a referenced library, but it may also be a path to a specific data element. The criteria defines the data to be returned for this element.

                                          ShortExpression describing additional data to be reported
                                          Control1..1
                                          TypeExpression
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))