Quality Measure Implementation Guide (STU3 Ballot)
2.1.0 - ballot

Quality Measure Implementation Guide (STU3 Ballot), published by Clinical Quality Information WG. This is not an authorized publication; it is the continuous build for version 2.1.0). 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

Definitions for the publishable-measure-cqfm resource profile.

1. Measure
Definition

The Measure resource provides the definition of a quality measure.

Control1..1
InvariantsDefined on this element
dom-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()))
2. Measure.id
Definition

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

Control0..1
Typestring
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.

3. 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.

Control1..1
TypeMeta
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. Measure.meta.id
Definition

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

Control0..1
Typestring
5. Measure.meta.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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
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())
SlicingThis element introduces a set of slices on Measure.meta.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
6. Measure.meta.versionId
Definition

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

Control0..1
Typeid
Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. Measure.meta.lastUpdated
Definition

When the resource last changed - e.g. when the version changed.

Control0..1
Typeinstant
Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
8. Measure.meta.source
Definition

A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

Control0..1
Typeuri
Comments

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
9. Measure.meta.profile
Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

Control1..*
Typecanonical(StructureDefinition)
Must Supporttrue
Requirements

A measure must declare its profile.

Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
10. Measure.meta.security
Definition

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

Control0..*
BindingThe codes SHALL be taken from All Security Labels; other codes may be used where these codes are not suitable Security Labels from the Healthcare Privacy and Security Classification System.

TypeCoding
Comments

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
11. Measure.meta.tag
Definition

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

Control0..*
BindingFor example codes, see CommonTags Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

TypeCoding
Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
12. 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.

Control0..1
Typeuri
Is Modifiertrue
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
13. Measure.language
Definition

The base language in which the resource is written.

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages
Max Binding: AllLanguages A human language.

Typecode
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).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
14. 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.

Control1..1
TypeNarrative
Must Supporttrue
Requirements

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

Alternate Namesnarrative, html, xhtml, display
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
15. 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.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained 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.

16. Measure.extension
Definition

An Extension

Control0..*
TypeExtension
InvariantsDefined on this element
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())
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
17. Measure.extension:comment
SliceNamecomment
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(CQFMArtifactComment) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
Must Supporttrue
InvariantsDefined on this element
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())
18. Measure.extension:allocation
SliceNameallocation
Definition

Specifies additional guidance for determining how the allocation for the measure specification should be performed.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(CQFMAllocation) (Extension Type: markdown)
Must Supporttrue
InvariantsDefined on this element
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())
19. Measure.extension:softwaresystem
SliceNamesoftwaresystem
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.

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(CQFMSoftwareSystem) (Extension Type: Reference(CQFMDevice))
Must Supporttrue
InvariantsDefined on this element
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())
20. 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).

Control0..*
TypeExtension
Is Modifiertrue
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
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.

InvariantsDefined on this element
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())
21. 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.

Control1..1
Typeuri
Requirements

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

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. 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.

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

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

InvariantsDefined on this element
ele-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
23. Measure.identifier:versionIndependentIdentifier
SliceNameversionIndependentIdentifier
Definition

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

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

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

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
24. 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.

Control0..1
Typestring
25. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
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())
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
26. Measure.identifier:versionIndependentIdentifier.use
Definition

The purpose of this identifier.

Control1..1
BindingThe codes SHALL be taken from IdentifierUse Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue
Must Supporttrue
Requirements

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

Comments

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

Fixed Valueofficial
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
27. 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.

Control1..1
BindingThe codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

TypeCodeableConcept
Must Supporttrue
Requirements

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

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.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
    <code value="version-independent"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
28. Measure.identifier:versionIndependentIdentifier.system
Definition

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

Control1..1
Typeuri
Must Supporttrue
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.

Comments

Identifier.system is always case sensitive.

Fixed Valueurn:ietf:rfc:3986
Example
General:http://www.acme.com/identifiers/patient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. 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.

Control1..1
Typestring
Must Supporttrue
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.

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
30. Measure.identifier:versionIndependentIdentifier.period
Definition

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

Control0..1
TypePeriod
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
31. Measure.identifier:versionIndependentIdentifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization)
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
32. Measure.identifier:versionSpecificIdentifier
SliceNameversionSpecificIdentifier
Definition

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

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

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

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
33. 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.

Control0..1
Typestring
34. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
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())
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
35. Measure.identifier:versionSpecificIdentifier.use
Definition

The purpose of this identifier.

Control1..1
BindingThe codes SHALL be taken from IdentifierUse Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue
Must Supporttrue
Requirements

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

Comments

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

Fixed Valueofficial
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
36. 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.

Control1..1
BindingThe codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

TypeCodeableConcept
Must Supporttrue
Requirements

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

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.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
    <code value="version-specific"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
37. Measure.identifier:versionSpecificIdentifier.system
Definition

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

Control1..1
Typeuri
Must Supporttrue
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.

Comments

Identifier.system is always case sensitive.

Fixed Valueurn:ietf:rfc:3986
Example
General:http://www.acme.com/identifiers/patient
InvariantsDefined on this element
ele-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.

Control1..1
Typestring
Must Supporttrue
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.

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
39. Measure.identifier:versionSpecificIdentifier.period
Definition

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

Control0..1
TypePeriod
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
40. Measure.identifier:versionSpecificIdentifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization)
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
41. Measure.identifier:shortName
SliceNameshortName
Definition

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

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

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

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
42. 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.

Control0..1
Typestring
43. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
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())
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
44. Measure.identifier:shortName.use
Definition

The purpose of this identifier.

Control1..1
BindingThe codes SHALL be taken from IdentifierUse Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue
Must Supporttrue
Requirements

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

Comments

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

Fixed Valueusual
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
45. 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.

Control1..1
BindingThe codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

TypeCodeableConcept
Must Supporttrue
Requirements

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

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.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
    <code value="short-name"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
46. Measure.identifier:shortName.system
Definition

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

Control0..1
Typeuri
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.

Comments

Identifier.system is always case sensitive.

Example
General:http://www.acme.com/identifiers/patient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
47. 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.

Control1..1
Typestring
Must Supporttrue
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.

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
48. Measure.identifier:shortName.period
Definition

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

Control0..1
TypePeriod
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
49. Measure.identifier:shortName.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization)
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
50. Measure.identifier:endorserIdentifier
SliceNameendorserIdentifier
Definition

An identifier assigned by the measure endorser.

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

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

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
51. 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.

Control0..1
Typestring
52. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
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())
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
53. Measure.identifier:endorserIdentifier.use
Definition

The purpose of this identifier.

Control1..1
BindingThe codes SHALL be taken from IdentifierUse Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue
Must Supporttrue
Requirements

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

Comments

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

Fixed Valueofficial
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
54. 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.

Control1..1
BindingThe codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

TypeCodeableConcept
Must Supporttrue
Requirements

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

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.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
    <code value="endorser"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
55. Measure.identifier:endorserIdentifier.system
Definition

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

Control0..1
Typeuri
Must Supporttrue
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.

Comments

Identifier.system is always case sensitive.

Example
General:http://www.acme.com/identifiers/patient
InvariantsDefined on this element
ele-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.

Control1..1
Typestring
Must Supporttrue
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.

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
57. Measure.identifier:endorserIdentifier.period
Definition

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

Control0..1
TypePeriod
InvariantsDefined on this element
ele-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.

Control1..1
TypeReference(Organization)
Must Supporttrue
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
59. Measure.identifier:publisherIdentifier
SliceNamepublisherIdentifier
Definition

An identifier assigned by the measure publisher.

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

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

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
60. 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.

Control0..1
Typestring
61. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
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())
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
62. Measure.identifier:publisherIdentifier.use
Definition

The purpose of this identifier.

Control1..1
BindingThe codes SHALL be taken from IdentifierUse Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue
Must Supporttrue
Requirements

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

Comments

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

Fixed Valueofficial
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
63. 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.

Control1..1
BindingThe codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

TypeCodeableConcept
Must Supporttrue
Requirements

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

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.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/identifier-type"/>
    <code value="publisher"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
64. Measure.identifier:publisherIdentifier.system
Definition

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

Control0..1
Typeuri
Must Supporttrue
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.

Comments

Identifier.system is always case sensitive.

Example
General:http://www.acme.com/identifiers/patient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
65. 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.

Control1..1
Typestring
Must Supporttrue
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.

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
66. Measure.identifier:publisherIdentifier.period
Definition

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

Control0..1
TypePeriod
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
67. Measure.identifier:publisherIdentifier.assigner
Definition

Organization that issued/manages the identifier.

Control1..1
TypeReference(Organization)
Must Supporttrue
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
68. 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.

NoteThis is a business versionId, not a resource version id (see discussion)
Control1..1
Typestring
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].

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
69. 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.

Control1..1 This element is affected by the following invariants: inv-0
Typestring
Requirements

Support human navigation and code generation.

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
70. Measure.title
Definition

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

Control1..1
Typestring
Must Supporttrue
Requirements

A published measure must specify a human-friendly title.

Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
71. Measure.subtitle
Definition

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

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
72. Measure.status
Definition

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

Control1..1
BindingThe codes SHALL be taken from PublicationStatus The lifecycle status of an artifact.

Typecode
Is Modifiertrue
Requirements

A published measure must have a status of active.

Comments

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

Fixed Valueactive
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
73. 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.

Control1..1
Typeboolean
Requirements

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

Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
74. 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.

Control0..1
BindingThe codes SHALL be taken from SubjectType; other codes may be used where these codes are not suitable 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]
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.

Meaning if MissingPatient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
75. 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.

Control1..1
TypedateTime
Must Supporttrue
Requirements

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

Alternate NamesRevision Date
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
76. Measure.publisher
Definition

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

Control1..1
Typestring
Requirements

A published measure must provide publisher information.

Alternate Namessteward
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
77. Measure.contact
Definition

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

Control1..*
TypeContactDetail
Must Supporttrue
Requirements

A published measure must provide contact information for the publisher.

Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
78. Measure.description
Definition

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

Control1..1
Typemarkdown
Alternate Namesscope
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).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
79. 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.

Control0..*
TypeUsageContext
Must Supporttrue
Requirements

Assist in searching for appropriate content.

Comments

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

InvariantsDefined on this element
ele-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.useContext. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ code
80. Measure.useContext:qualityProgram
SliceNamequalityProgram
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.

Control1..1
TypeUsageContext
Must Supporttrue
Requirements

Assist in searching for appropriate content.

Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
81. Measure.useContext:qualityProgram.id
Definition

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

Control0..1
Typestring
82. Measure.useContext:qualityProgram.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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
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())
SlicingThis element introduces a set of slices on Measure.useContext.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
83. Measure.useContext:qualityProgram.code
Definition

A code that identifies the type of context being specified by this usage context.

Control1..1
BindingThe codes SHALL be taken from UsageContextType; other codes may be used where these codes are not suitable A code that specifies a type of context being specified by a usage context.

TypeCoding
Must Supporttrue
Pattern Value<valueCoding xmlns="http://hl7.org/fhir">
  <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
  <code value="program"/>
</valueCoding>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
84. Measure.useContext:qualityProgram.value[x]
Definition

A value that defines the context specified in this context of use. The interpretation of the value is defined by the code.

Control1..1
BindingThe codes SHALL be taken from Quality Programs; other codes may be used where these codes are not suitable The quality programs

TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
85. Measure.jurisdiction
Definition

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

Control0..*
BindingThe codes SHALL be taken from Jurisdiction ValueSet; other codes may be used where these codes are not suitable Countries and regions within which this artifact is targeted for use.

TypeCodeableConcept
Must Supporttrue
Comments

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

InvariantsDefined on this element
ele-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.

Control0..1
Typemarkdown
Must Supporttrue
Requirements

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

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
87. Measure.usage
Definition

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

Control0..1
Typestring
Must Supporttrue
Requirements

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
88. 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.

Control0..1
Typemarkdown
Must Supporttrue
Requirements

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

Alternate NamesLicense, Restrictions
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
89. 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.

Control1..1
Typedate
Must Supporttrue
Requirements

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

Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
90. 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.

Control1..1
Typedate
Must Supporttrue
Requirements

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

Comments

If specified, this date follows the original approval date.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
91. Measure.effectivePeriod
Definition

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

Control0..1
TypePeriod
Must Supporttrue
Requirements

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

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
92. 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.

Control0..1
Typestring
93. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
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())
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
94. Measure.effectivePeriod.extension:anchor
SliceNameanchor
Definition

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

Control0..1
TypeExtension(CQFMEffectivePeriodAnchor) (Extension Type: dateTime)
Must Supporttrue
InvariantsDefined on this element
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())
95. Measure.effectivePeriod.extension:duration
SliceNameduration
Definition

Specifies the reporting period for the measure.

Control0..1
TypeExtension(CQFMEffectivePeriodDuration) (Extension Type: Duration)
Must Supporttrue
InvariantsDefined on this element
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())
96. Measure.effectivePeriod.start
Definition

The start of the period. The boundary is inclusive.

Control0..1 This element is affected by the following invariants: per-1
TypedateTime
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
97. 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.

Control0..1 This element is affected by the following invariants: per-1
TypedateTime
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.

Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
98. 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.

Control0..*
BindingFor example codes, see DefinitionTopic High-level categorization of the definition, used for searching, sorting, and filtering.

TypeCodeableConcept
Must Supporttrue
Requirements

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
99. Measure.author
Definition

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

Control0..*
TypeContactDetail
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
100. Measure.editor
Definition

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

Control0..*
TypeContactDetail
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
101. Measure.reviewer
Definition

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

Control0..*
TypeContactDetail
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
102. Measure.endorser
Definition

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

Control0..*
TypeContactDetail
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
103. Measure.relatedArtifact
Definition

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

Control0..*
TypeRelatedArtifact
Must Supporttrue
Requirements

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

Comments

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

InvariantsDefined on this element
ele-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
104. Measure.relatedArtifact:predecessor
SliceNamepredecessor
Definition

Reference to a predecessor measure that this measure is replacing.

Control0..1
TypeRelatedArtifact
Must Supporttrue
Requirements

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

Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
105. 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.

Control0..1
Typestring
106. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
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())
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
107. Measure.relatedArtifact:predecessor.type
Definition

The type of relationship to the related artifact.

Control1..1
BindingThe codes SHALL be taken from RelatedArtifactType The type of relationship to the related artifact.

Typecode
Must Supporttrue
Fixed Valuepredecessor
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
108. 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.

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
109. Measure.relatedArtifact:predecessor.display
Definition

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

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
110. Measure.relatedArtifact:predecessor.citation
Definition

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

Control0..1
Typemarkdown
Comments

Additional structured information about citations should be captured as extensions.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
111. Measure.relatedArtifact:predecessor.url
Definition

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

Control0..1
Typeurl
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).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
112. Measure.relatedArtifact:predecessor.document
Definition

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

Control0..1
TypeAttachment
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
113. Measure.relatedArtifact:predecessor.resource
Definition

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

Control1..1
Typecanonical(Measure)
Must Supporttrue
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
114. Measure.relatedArtifact:citation
SliceNamecitation
Definition

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

Control0..*
TypeRelatedArtifact
Must Supporttrue
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.

Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
115. 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.

Control0..1
Typestring
116. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
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())
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
117. Measure.relatedArtifact:citation.extension:isPrimaryCitation
SliceNameisPrimaryCitation
Definition

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

Control0..1
TypeExtension(CQFMIsPrimaryCitation) (Extension Type: boolean)
InvariantsDefined on this element
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())
118. Measure.relatedArtifact:citation.extension:publicationStatus
SliceNamepublicationStatus
Definition

Specifies the publication status of the referenced artifacts.

Control0..1
TypeExtension(CQFMPublicationStatus) (Extension Type: code)
InvariantsDefined on this element
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())
119. Measure.relatedArtifact:citation.extension:publicationDate
SliceNamepublicationDate
Definition

Specifies the publication date of the referenced artifacts.

Control0..1
TypeExtension(CQFMPublicationDate) (Extension Type: date)
InvariantsDefined on this element
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())
120. Measure.relatedArtifact:citation.type
Definition

The type of relationship to the related artifact.

Control1..1
BindingThe codes SHALL be taken from RelatedArtifactType The type of relationship to the related artifact.

Typecode
Must Supporttrue
Fixed Valuecitation
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
121. 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.

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
122. Measure.relatedArtifact:citation.display
Definition

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

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
123. Measure.relatedArtifact:citation.citation
Definition

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

Control0..1
Typemarkdown
Comments

Additional structured information about citations should be captured as extensions.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
124. Measure.relatedArtifact:citation.url
Definition

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

Control0..1
Typeurl
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).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
125. Measure.relatedArtifact:citation.document
Definition

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

Control0..1
TypeAttachment
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
126. Measure.relatedArtifact:citation.resource
Definition

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

Control0..1
Typecanonical(Resource)
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
127. Measure.relatedArtifact:derived-from
SliceNamederived-from
Definition

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

Control0..*
TypeRelatedArtifact
Must Supporttrue
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.

Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
128. 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.

Control0..1
Typestring
129. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
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())
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
130. Measure.relatedArtifact:derived-from.type
Definition

The type of relationship to the related artifact.

Control1..1
BindingThe codes SHALL be taken from RelatedArtifactType The type of relationship to the related artifact.

Typecode
Must Supporttrue
Fixed Valuederived-from
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
131. 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.

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
132. Measure.relatedArtifact:derived-from.display
Definition

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

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
133. Measure.relatedArtifact:derived-from.citation
Definition

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

Control0..1
Typemarkdown
Comments

Additional structured information about citations should be captured as extensions.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
134. Measure.relatedArtifact:derived-from.url
Definition

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

Control0..1
Typeurl
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).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
135. Measure.relatedArtifact:derived-from.document
Definition

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

Control0..1
TypeAttachment
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
136. Measure.relatedArtifact:derived-from.resource
Definition

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

Control0..1
Typecanonical(Measure)
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
137. Measure.library
Definition

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

Control0..1 This element is affected by the following invariants: cqm-2
Typecanonical(CQFMLibrary)
Must Supporttrue
Requirements

A measure MUST provide one primary library reference containing population criteria definitions for the measure.

InvariantsDefined on this element
cqm-2: Measures utilizing CQL SHALL reference one and only one CQL library (and that referenced library MUST be the primary library for the measure) (: exists())
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
138. 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.

Control0..1
Typemarkdown
Must Supporttrue
Requirements

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
139. 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.

Control1..1
BindingThe codes SHALL be taken from MeasureScoring; other codes may be used where these codes are not suitable The scoring type of the measure.

TypeCodeableConcept
Must Supporttrue
Requirements

A measure must indicate the scoring method used for the measure.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
140. Measure.compositeScoring
Definition

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

Control0..1
BindingThe codes SHALL be taken from CompositeMeasureScoring; other codes may be used where these codes are not suitable The composite scoring method of the measure.

TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
141. 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.

Control1..*
BindingThe codes SHALL be taken from CQFM Measure Type; other codes may be used where these codes are not suitable The type of measure

TypeCodeableConcept
Must Supporttrue
Requirements

A measure must indicate the type of the measure.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
142. 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.

Control0..1
Typestring
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
143. Measure.rateAggregation
Definition

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

Control0..1
Typestring
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).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
144. 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.

Control0..1
Typemarkdown
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
145. Measure.clinicalRecommendationStatement
Definition

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

Control0..1
Typemarkdown
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
146. 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).

Control1..1
BindingThe codes SHALL be taken from MeasureImprovementNotation 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
Must Supporttrue
Requirements

A measure must indicate the improvement notation used for the measure.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
147. Measure.definition
Definition

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

Control0..*
Typemarkdown
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
148. Measure.definition.id
Definition

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

Control0..1
Typestring
149. Measure.definition.extension
Definition

An Extension

Control0..*
TypeExtension
InvariantsDefined on this element
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())
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
150. Measure.definition.extension:definitionTerm
SliceNamedefinitionTerm
Definition

Specifies a term and its associated definition.

Control1..1 This element is affected by the following invariants: ele-1
TypeExtension(CQFMDefinitionTerm) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
InvariantsDefined on this element
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())
151. Measure.definition.value
Definition

Primitive value for markdown

Control0..1
Typestring
152. Measure.guidance
Definition

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

Control0..1
Typemarkdown
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
153. Measure.group
Definition

A group of population criteria for the measure.

Control0..*
TypeBackboneElement
Must Supporttrue
Requirements

A measure must specify at least one population group.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
154. 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.

Control0..1 This element is affected by the following invariants: cqm-3
Typestring
Must Supporttrue
InvariantsDefined on this element
cqm-3: Group identifiers SHOULD use the convention: "group-[group number]", where [group number] corresponds with the group naming convention for the criteria within the group (: value.startsWith('group-'))
155. Measure.group.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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
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())
156. 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).

Control0..*
TypeExtension
Is Modifiertrue
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
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.

InvariantsDefined on this element
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())
157. 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.

Control0..1
TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
158. Measure.group.description
Definition

The human readable description of this population group.

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
159. Measure.group.population
Definition

A population criteria for the measure.

Control1..*
TypeBackboneElement
Must Supporttrue
Requirements

A measure must specify at least one population for each population group.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
160. 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.

Control1..1
Typestring
Must Supporttrue
Requirements

A measure must specify at least one population for each population group.

161. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
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())
162. 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).

Control0..*
TypeExtension
Is Modifiertrue
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
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.

InvariantsDefined on this element
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())
163. Measure.group.population.code
Definition

The type of population criteria.

Control1..1
BindingThe codes SHALL be taken from MeasurePopulationType; other codes may be used where these codes are not suitable The type of population.

TypeCodeableConcept
Must Supporttrue
Requirements

A measure must specify the type of population criteria.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
164. Measure.group.population.description
Definition

The human readable description of this population criteria.

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
165. Measure.group.population.criteria
Definition

The name of a valid referenced CQL expression (MUST NOT be namespaced) that defines this population criteria.

Control1..1
TypeExpression
Must Supporttrue
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.

InvariantsDefined on this element
cqm-4: Group population criteria SHOULD be simple expression names found within the primary library for the measure. The criteria SHOULD NOT include a namespace. (: value.startsWith(library).not())
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
166. 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.

Control0..*
TypeBackboneElement
Must Supporttrue
Requirements

A measure should provide stratification information if appropriate for the measure content.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
167. 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.

Control1..1
Typestring
Must Supporttrue
Requirements

A measure should provide stratification information if appropriate for the measure content.

168. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
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())
169. 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).

Control0..*
TypeExtension
Is Modifiertrue
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
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.

InvariantsDefined on this element
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())
170. 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.

Control0..1
TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
171. Measure.group.stratifier.description
Definition

The human readable description of this stratifier criteria.

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
172. Measure.group.stratifier.criteria
Definition

The name of a valid referenced CQL expression (MUST NOT be namespaced) that defines this stratifier criteria.

Control0..1
TypeExpression
Must Supporttrue
InvariantsDefined on this element
cqm-5: Group stratifier criteria SHOULD be simple expression names found within the primary library for the measure. The criteria SHOULD NOT include a namespace. (: value.startsWith(library).not())
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
173. 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.

Control0..*
TypeBackboneElement
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
174. 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.

Control0..1
Typestring
175. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
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())
176. 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).

Control0..*
TypeExtension
Is Modifiertrue
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
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.

InvariantsDefined on this element
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())
177. 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.

Control0..1
TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
178. Measure.group.stratifier.component.description
Definition

The human readable description of this stratifier criteria component.

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
179. 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.

Control1..1
TypeExpression
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
180. 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.

Control0..*
TypeBackboneElement
Must Supporttrue
Requirements

A measure should provide supplemental data appropriate for the measure content.

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.

InvariantsDefined on this element
cqm-6: Supplemental data SHALL use either criteria or path (: criteria.exists() or path.exists())
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
181. 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.

Control1..1
Typestring
Must Supporttrue
Requirements

A measure should provide supplemental data appropriate for the measure content.

182. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
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())
183. 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).

Control0..*
TypeExtension
Is Modifiertrue
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
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.

InvariantsDefined on this element
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())
184. 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.

Control0..1
TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
185. 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.

Control0..*
BindingThe codes SHALL be taken from MeasureDataUsage; other codes may be used where these codes are not suitable The intended usage for supplemental data elements in the measure.

TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
186. Measure.supplementalData.description
Definition

The human readable description of this supplemental data.

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
187. 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.

Control1..1
TypeExpression
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))