Data Exchange For Quality Measures Implementation Guide
5.0.0 - STU5 United States of America flag

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

Resource Profile: DEQMIndividualMeasureReportProfile - Detailed Descriptions

Active as of 2021-04-23

Definitions for the indv-measurereport-deqm resource profile.

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

0. MeasureReport
Must Supportfalse
Invariantsdeqm-2: If the measure scoring is specified at the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required (extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains ('proportion' | 'ratio' | 'continuous-variable') implies improvementNotation.exists())
deqm-3: ensures scoring is either specified only at the root, or on all groups (extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists() xor (group.extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists() and group.extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').count() = group.count()))
deqm-5: If the scoring, at either the root level or the group level, is other than composite then the group.population cardinality is >=1 ((extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains ('composite')).not() or (group.extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains ('composite')).not() implies group.population.count()>=1)
deqm-6: If the measure scoring type is 'proportion' then the measureScore SHALL be a numerical value between 0 and 1 ((extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains 'proportion' or group.extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains 'proportion') implies group.all(measureScore.value >= 0.0 and measureScore.value <=1.0))
deqm-7: If group.stratifier exists, then stratifier.code or the stratifier.stratum.component.code is present, but not both (group.stratifier.exists() implies group.stratifier.code.exists() xor group.stratifier.stratum.component.code.exists())
2. MeasureReport.extension:reportingProgram
Slice NamereportingProgram
Control0..1
TypeExtension(DEQM Reporting Program Extension) (Extension Type: Choice of: CodeableConcept, canonical(CQFM Publishable Manifest))
Must Supporttrue
4. MeasureReport.extension:inputParameters
Slice NameinputParameters
Control0..1
TypeExtension(Input parameters) (Extension Type: Reference(Parameters))
Must Supporttrue
6. MeasureReport.extension:supplementalData
Slice NamesupplementalData
Control0..*
TypeExtension(Supplemental Data Extension) (Extension Type: Reference(Resource))
Must Supporttrue
8. MeasureReport.extension:supplementalData.extension:criteriaReference
Slice NamecriteriaReference
Control0..1
TypeExtension(Criteria Reference Extension) (Extension Type: string)
Must Supporttrue
10. MeasureReport.extension:supplementalData.extension:description
Slice Namedescription
ShortDescription of the supplemental data
Control0..1
TypeExtension(Measure Report Population Description) (Extension Type: markdown)
Must Supporttrue
12. MeasureReport.extension:scoring
Slice Namescoring
Shortproportion | ratio | continuous-variable | cohort | composite
Control0..1
This element is affected by the following invariants: deqm-2, deqm-3
TypeExtension(DEQM Measure Scoring Extension) (Extension Type: CodeableConcept)
Must Supporttrue
14. MeasureReport.extension:vendor
Slice Namevendor
Control0..1
TypeExtension(DEQM Reporting Vendor Extension) (Extension Type: Reference(QICore Organization))
Must Supporttrue
16. MeasureReport.extension:cehrt
Slice Namecehrt
ShortCMS EHR Certifciation ID
Control0..1
TypeExtension(DEQM Certification Identifier Extension) (Extension Type: Identifier)
Must Supporttrue
18. MeasureReport.extension:cehrt.valueIdentifier
Control1..1
TypeIdentifier
Must Supporttrue
Pattern Value{
  "system" : "urn:oid:2.16.840.1.113883.3.2074.1"
}
20. MeasureReport.extension:software
Slice Namesoftware
Control0..*
TypeExtension(CRMI Software System) (Extension Type: Reference(CRMI Software System Device))
Must Supporttrue
22. MeasureReport.extension:location
Slice Namelocation
Control0..*
TypeExtension(DEQM Data Location Extension) (Extension Type: Reference(QICore Location))
24. MeasureReport.status
Must Supporttrue
26. MeasureReport.type
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Requirements

For individual quality meaure reporting, this report is constrained to reporting on an individual.

Fixed Valueindividual
28. MeasureReport.measure
Typecanonical(CRMI Shareable Measure)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Requirements

This will indicate the measure being reported on. For example, the cannonical uri location for the MRP measure.

30. MeasureReport.subject
Control1..1
TypeReference(QICore Patient, QICore Practitioner, QICore PractitionerRole, QICore Location, QICore Device, QICore RelatedPerson, QICore Simple Observation)
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
32. MeasureReport.date
ShortWhen the report was generated. Note: The language in R5 was changed to calculated. We are clarifying that intent.
Control1..1
Must Supporttrue
34. MeasureReport.reporter
Definition

Organization that generated the MeasureReport

ShortOrganization that generated the MeasureReport
Control1..1
TypeReference(QICore Organization)
Must Supporttrue
36. MeasureReport.reporter.extension:group
Slice Namegroup
Control0..1
TypeExtension(DEQM Reporter Group Extension) (Extension Type: Reference(Group))
Must Supporttrue
38. MeasureReport.period
ShortThe period for which the report was calculated. For the gaps in care use case, this is referred to as the gaps through period.
Control1..1
This element is affected by the following invariants: deqm-1
TypePeriod
Must Supporttrue
Invariantsdeqm-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) (start.toString().length()>9 and end.toString().length()>9)
40. MeasureReport.period.start
Control1..1
Must Supporttrue
42. MeasureReport.period.end
Control1..1
Must Supporttrue
44. MeasureReport.improvementNotation
Control0..1
This element is affected by the following invariants: deqm-2
Must Supporttrue
46. MeasureReport.group
Control0..*
Must Supporttrue
Invariantsdeqm-4: If the measure scoring is specified on the group and the scoring type is 'proportion', 'ratio', or 'continuous-variable' then the groupImprovementNotation element is required. ((extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists() and extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains ('proportion' | 'ratio' | 'continuous-variable')) implies extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-groupImprovementNotation').exists())
48. MeasureReport.group.id
Must Supporttrue
50. MeasureReport.group.extension:scoring
Slice Namescoring
Shortproportion | ratio | continuous-variable | cohort | composite
Control0..1
This element is affected by the following invariants: deqm-3
TypeExtension(DEQM Measure Scoring Extension) (Extension Type: CodeableConcept)
Must Supporttrue
52. MeasureReport.group.extension:calculatedDate
Slice NamecalculatedDate
Control0..1
TypeExtension(DEQM Calculated Date Extension) (Extension Type: dateTime)
Must Supporttrue
54. MeasureReport.group.extension:groupImprovementNotation
Slice NamegroupImprovementNotation
Shortincrease | decrease
Control0..1
This element is affected by the following invariants: deqm-4
TypeExtension(DEQM Group Improvement Notation Extension) (Extension Type: CodeableConcept)
Must Supporttrue
56. MeasureReport.group.extension:description
Slice Namedescription
ShortDescription of the group
Control0..1
TypeExtension(Measure Report Population Description) (Extension Type: markdown)
Must Supporttrue
58. MeasureReport.group.extension:numeratorMembership
Slice NamenumeratorMembership
ShortProvides the number of subjects in the numerator population membership.
Control0..1
TypeExtension(Numerator Membership) (Extension Type: Quantity)
Must Supporttrue
60. MeasureReport.group.extension:denominatorMembership
Slice NamedenominatorMembership
ShortProvides the number of subjects in the denominator population membership.
Control0..1
TypeExtension(Denominator Membership) (Extension Type: Quantity)
Must Supporttrue
62. MeasureReport.group.extension:measurePopulationMembership
Slice NamemeasurePopulationMembership
ShortProvides the number of subjects in the measure population membership.
Control0..1
TypeExtension(Measure Population Membership) (Extension Type: Quantity)
Must Supporttrue
64. MeasureReport.group.code
Must Supporttrue
66. MeasureReport.group.population
Must Supporttrue
Invariantsdeqm-8: The population must either have a count (integer) or a countQuantity (quantity), but not both. (extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists())
68. MeasureReport.group.population.extension:countQuantity
Slice NamecountQuantity
Definition

The count of the population represented as a Quantity. This is used in cases where the count may be a decimal value such as in a ratio measure.

ShortCount as a Quantity
Control0..1
This element is affected by the following invariants: deqm-8
TypeExtension(Count Quantity) (Extension Type: Quantity)
Must Supporttrue
70. MeasureReport.group.population.extension:description
Slice Namedescription
ShortDescription of the population
Control0..1
TypeExtension(Measure Report Population Description) (Extension Type: markdown)
Must Supporttrue
72. MeasureReport.group.population.code
Control1..1
Must Supporttrue
74. MeasureReport.group.population.count
Control0..1
This element is affected by the following invariants: deqm-8
Must Supporttrue
76. MeasureReport.group.population.subjectResults
Control0..0
Must Supportfalse
78. MeasureReport.group.measureScore
Comments

For individual reporting, the measure score is calculated for the individual. For a proportion measure, it would be 0.0 or 1.0 (indicating 0% or 100%).

Control0..1
This element is affected by the following invariants: deqm-6
Must Supporttrue
80. MeasureReport.group.measureScore.extension:altscoretype
Slice Namealtscoretype
Control0..1
TypeExtension(DEQM Alternate Score Type Extension) (Extension Type: Choice of: dateTime, CodeableConcept, Period, Range, Duration, boolean)
Must Supporttrue
82. MeasureReport.group.stratifier
84. MeasureReport.group.stratifier.extension:description
Slice Namedescription
ShortDescription of the stratifier
Control0..1
TypeExtension(Measure Report Population Description) (Extension Type: markdown)
Must Supporttrue
86. MeasureReport.group.stratifier.code
Definition

The meaning of this stratifier, as defined in the measure definition.

ShortWhat stratifier of the group
Control0..1
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
88. MeasureReport.group.stratifier.stratum
Must Supporttrue
90. MeasureReport.group.stratifier.stratum.population
Must Supporttrue
Invariantsdeqm-9: The stratum population must either have a count (integer) or a countQuantity (quantity), but not both. (extension('http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity').exists() xor count.exists())
92. MeasureReport.group.stratifier.stratum.population.extension
Control0..1
This element is affected by the following invariants: deqm-9
TypeExtension(Count Quantity) (Extension Type: Quantity)
Must Supporttrue
94. MeasureReport.group.stratifier.stratum.population.code
Control1..1
Must Supporttrue
96. MeasureReport.group.stratifier.stratum.population.count
Control1..1
This element is affected by the following invariants: deqm-9
Must Supporttrue
98. MeasureReport.evaluatedResource
Must Supporttrue
Requirements

To support the reporting of supplemental data elements.

100. MeasureReport.extension:message
Slice Namemessage
Control0..1
TypeExtension(Messages) (Extension Type: Reference(OperationOutcome))
Must Supporttrue
102. MeasureReport.evaluatedResource.extension:popref
Slice Namepopref
Control0..*
TypeExtension(Criteria Reference Extension) (Extension Type: string)
Must Supporttrue

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

0. MeasureReport
Definition

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

ShortResults of a measure evaluation
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information ((type != 'data-collection') or group.exists().not())
mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components (group.stratifier.stratum.all(value.exists() xor component.exists()))
deqm-2: If the measure scoring is specified at the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required (extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains ('proportion' | 'ratio' | 'continuous-variable') implies improvementNotation.exists())
deqm-3: ensures scoring is either specified only at the root, or on all groups (extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists() xor (group.extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists() and group.extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').count() = group.count()))
deqm-5: If the scoring, at either the root level or the group level, is other than composite then the group.population cardinality is >=1 ((extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains ('composite')).not() or (group.extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains ('composite')).not() implies group.population.count()>=1)
deqm-6: If the measure scoring type is 'proportion' then the measureScore SHALL be a numerical value between 0 and 1 ((extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains 'proportion' or group.extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains 'proportion') implies group.all(measureScore.value >= 0.0 and measureScore.value <=1.0))
deqm-7: If group.stratifier exists, then stratifier.code or the stratifier.stratum.component.code is present, but not both (group.stratifier.exists() implies group.stratifier.code.exists() xor group.stratifier.stratum.component.code.exists())
mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information ((type != 'data-collection') or group.exists().not())
mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components (group.stratifier.stratum.all(value.exists() xor component.exists()))
2. MeasureReport.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

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

Reference the reporting program by referencing their unique id specified in a Library resource that conforms to the Quality Program profile.

ShortReporting program
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(DEQM Reporting Program Extension) (Extension Type: Choice of: CodeableConcept, canonical(CQFM Publishable Manifest))
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. MeasureReport.extension:inputParameters
Slice NameinputParameters
Definition

Specifies the input parameters to the operation (such as a test case description or a data requirements or evaluate operation). This extension can be used as part of the result of an operation to indicate what the parameters were, but it can also be used as part of the definition of a test case to specify what the input parameters are expected to be for the test case.

ShortWhat parameters
Control0..1
TypeExtension(Input parameters) (Extension Type: Reference(Parameters))
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. MeasureReport.extension:supplementalData
Slice NamesupplementalData
Definition

Supplemental data described by the Measure.

ShortSupplemental Data
Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(Supplemental Data Extension) (Extension Type: Reference(Resource))
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. MeasureReport.extension:supplementalData.extension:criteriaReference
Slice NamecriteriaReference
Definition

Reference a criteria by specifying that criteria's unique id

ShortCriteria reference
Control0..1
TypeExtension(Criteria Reference Extension) (Extension Type: string)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. MeasureReport.extension:supplementalData.extension:description
Slice Namedescription
Definition

A description of the group, population, stratifier, or supplemental data definition on which it appears. This is typically a restatement of the description of the corresponding element in the Measure being reported, but may also include additional information gathered by the reporting process.

ShortDescription of the supplemental data
Control0..1
TypeExtension(Measure Report Population Description) (Extension Type: markdown)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. MeasureReport.extension:supplementalData.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Shortidentifies the meaning of the extension
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Control1..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
Fixed Valuehttp://hl7.org/fhir/StructureDefinition/measurereport-supplementalData
16. MeasureReport.extension:scoring
Slice Namescoring
Definition

An Extension

Shortproportion | ratio | continuous-variable | cohort | composite
Control0..1
This element is affected by the following invariants: ele-1, deqm-2, deqm-3
TypeExtension(DEQM Measure Scoring Extension) (Extension Type: CodeableConcept)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. MeasureReport.extension:vendor
Slice Namevendor
Definition

A reference to the vendor who queried the data, calculated results and/or generated the report.

ShortVendor information
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(DEQM Reporting Vendor Extension) (Extension Type: Reference(QICore Organization))
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
20. MeasureReport.extension:cehrt
Slice Namecehrt
Definition

An identifier that represents the EHR certication number (CERHT). See Certified EHR Technology For more information.

ShortCMS EHR Certifciation ID
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(DEQM Certification Identifier Extension) (Extension Type: Identifier)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
22. MeasureReport.extension:cehrt.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Shortidentifies the meaning of the extension
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Control1..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
Fixed Valuehttp://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-certificationIdentifier
24. MeasureReport.extension:cehrt.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

ShortValue of extension
Control10..1
TypeIdentifier, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on MeasureReport.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
  • 26. MeasureReport.extension:cehrt.value[x]:valueIdentifier
    Slice NamevalueIdentifier
    Definition

    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

    ShortValue of extension
    Control10..1
    TypeIdentifier, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Pattern Value{
      "system" : "urn:oid:2.16.840.1.113883.3.2074.1"
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. MeasureReport.extension:software
    Slice Namesoftware
    Definition

    Specifies the software systems used in the packaging and testing of knowledge artifacts. Specifically to support explicitly stating which versions of the various software components were used in the authoring, packaging, and testing.

    ShortExtension
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(CRMI Software System) (Extension Type: Reference(CRMI Software System Device))
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    30. MeasureReport.extension:location
    Slice Namelocation
    Definition

    Location from which reported data was gathered. This extension is used to provide the location(s) from which reported data was gathered in a MeasureReport, such as individual, summary and data exchange measure report.

    ShortLocation(s) from which reported data was gathered
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(DEQM Data Location Extension) (Extension Type: Reference(QICore Location))
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    32. MeasureReport.extension:message
    Slice Namemessage
    Definition

    An OperationOutcome resource with information, warning, or error messages that were generated as part of processing an operation.

    ShortEvaluation messages
    Control0..1
    TypeExtension(Messages) (Extension Type: Reference(OperationOutcome))
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    34. MeasureReport.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

    The MeasureReport status. No data will be available until the MeasureReport status is complete.

    Shortcomplete | pending | error
    Comments

    This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

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

    The status of the measure report.

    Typecode
    Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    38. MeasureReport.type
    Definition

    The type of measure report. This may be an individual report, which provides the score for the measure for an individual member of the population; a subject-listing, which returns the list of members that meet the various criteria in the measure; a summary report, which returns a population count for each of the criteria in the measure; or a data-collection, which enables the MeasureReport to be used to exchange the data-of-interest for a quality measure.

    Shortindividual | subject-list | summary | data-collection
    Comments

    Data-collection reports are used only to communicate data-of-interest for a measure. They do not necessarily include all the data for a particular subject or population, but they may.

    Control1..1
    This element is affected by the following invariants: mrp-1
    BindingThe codes SHALL be taken from MeasureReportTypehttp://hl7.org/fhir/ValueSet/measure-report-type|4.0.1
    (required to http://hl7.org/fhir/ValueSet/measure-report-type|4.0.1)

    The type of the measure report.

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

    A reference to the Measure that was calculated to produce this report.

    ShortWhat measure was calculated
    Control1..1
    Typecanonical(Measure)
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    42. MeasureReport.subject
    Definition

    Optional subject identifying the individual or individuals the report is for.

    ShortWhat individual(s) the report is for
    Control0..1
    TypeReference(Patient, Practitioner, PractitionerRole, Location, Device, RelatedPerson, Group)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. MeasureReport.date
    Definition

    The date this measure report was generated.

    ShortWhen the report was generated
    Control0..1
    TypedateTime
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    46. MeasureReport.reporter
    Definition

    The individual, location, or organization that is reporting the data.

    ShortWho is reporting the data
    Control0..1
    TypeReference(Practitioner, PractitionerRole, Location, Organization)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    48. MeasureReport.period
    Definition

    The reporting period for which the report was calculated.

    ShortWhat period the report covers
    Control1..1
    TypePeriod
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    50. MeasureReport.improvementNotation
    Definition

    Whether improvement in the measure is noted by an increase or decrease in the measure score.

    Shortincrease | decrease
    Comments

    This element is typically defined by the measure, but reproduced here to ensure the measure score can be interpreted. The element is labeled as a modifier because it changes the interpretation of the reported measure score.

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

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

    TypeCodeableConcept
    Is Modifiertrue because Improvement notation determines how to interpret the measure score (i.e. whether an increase is an improvement)
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    52. MeasureReport.group
    Definition

    The results of the calculation, one for each population group in the measure.

    ShortMeasure results for each group
    Control0..*
    This element is affected by the following invariants: mrp-1
    TypeBackboneElement
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    54. MeasureReport.group.id
    Definition

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

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

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

    The meaning of the population group as defined in the measure definition.

    ShortMeaning of the group
    Control0..1
    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    60. MeasureReport.group.population
    Definition

    The populations that make up the population group, one for each type of population appropriate for the measure.

    ShortThe populations in the group
    Control0..*
    TypeBackboneElement
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    62. MeasureReport.group.population.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

    The type of the population.

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

    The type of population (e.g. initial, numerator, denominator, etc.).

    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    66. MeasureReport.group.population.count
    Definition

    The number of members of the population.

    ShortSize of the population
    Control0..1
    Typeinteger
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    68. MeasureReport.group.population.subjectResults
    Definition

    This element refers to a List of subject level MeasureReport resources, one for each subject in this population.

    ShortFor subject-list reports, the subject results in this population
    Control0..1
    TypeReference(List)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    70. MeasureReport.group.measureScore
    Definition

    The measure score for this population group, calculated as appropriate for the measure type and scoring method, and based on the contents of the populations defined in the group.

    ShortWhat score this group achieved
    Control0..1
    TypeQuantity
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    72. MeasureReport.evaluatedResource
    Definition

    A reference to a Bundle containing the Resources that were used in the calculation of this measure.

    ShortWhat data was used to calculate the measure score
    Control0..*
    TypeReference(Resource)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    74. MeasureReport.evaluatedResource.extension:popref
    Slice Namepopref
    Definition

    Reference a criteria by specifying that criteria's unique id

    ShortCriteria reference
    Control0..*
    TypeExtension(Criteria Reference Extension) (Extension Type: string)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())

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

    0. MeasureReport
    Definition

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

    ShortResults of a measure evaluation
    Control0..*
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    dom-6: A resource should have narrative for robust management (text.`div`.exists())
    mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information ((type != 'data-collection') or group.exists().not())
    mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components (group.stratifier.stratum.all(value.exists() xor component.exists()))
    deqm-2: If the measure scoring is specified at the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required (extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains ('proportion' | 'ratio' | 'continuous-variable') implies improvementNotation.exists())
    deqm-3: ensures scoring is either specified only at the root, or on all groups (extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists() xor (group.extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').exists() and group.extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').count() = group.count()))
    deqm-5: If the scoring, at either the root level or the group level, is other than composite then the group.population cardinality is >=1 ((extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains ('composite')).not() or (group.extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains ('composite')).not() implies group.population.count()>=1)
    deqm-6: If the measure scoring type is 'proportion' then the measureScore SHALL be a numerical value between 0 and 1 ((extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains 'proportion' or group.extension('http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring').value.coding.code contains 'proportion') implies group.all(measureScore.value >= 0.0 and measureScore.value <=1.0))
    deqm-7: If group.stratifier exists, then stratifier.code or the stratifier.stratum.component.code is present, but not both (group.stratifier.exists() implies group.stratifier.code.exists() xor group.stratifier.stratum.component.code.exists())
    2. MeasureReport.id
    Definition

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

    ShortLogical id of this artifact
    Comments

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

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

    The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

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

    A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

    ShortA set of rules under which this content was created
    Comments

    Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

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

    The base language in which the resource is written.

    ShortLanguage of the resource content
    Comments

    Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

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

    A human language.

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

    A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

    ShortText summary of the resource, for human interpretation
    Comments

    Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

    Control0..1
    TypeNarrative
    Is Modifierfalse
    Summaryfalse
    Alternate Namesnarrative, html, xhtml, display
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. MeasureReport.contained
    Definition

    These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

    ShortContained, inline Resources
    Comments

    This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

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

    An Extension

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

      Reference the reporting program by referencing their unique id specified in a Library resource that conforms to the Quality Program profile.

      ShortReporting program
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(DEQM Reporting Program Extension) (Extension Type: Choice of: CodeableConcept, canonical(CQFM Publishable Manifest))
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      18. MeasureReport.extension:inputParameters
      Slice NameinputParameters
      Definition

      Specifies the input parameters to the operation (such as a test case description or a data requirements or evaluate operation). This extension can be used as part of the result of an operation to indicate what the parameters were, but it can also be used as part of the definition of a test case to specify what the input parameters are expected to be for the test case.

      ShortWhat parameters
      Control0..1
      TypeExtension(Input parameters) (Extension Type: Reference(Parameters))
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      20. MeasureReport.extension:supplementalData
      Slice NamesupplementalData
      Definition

      Supplemental data described by the Measure.

      ShortSupplemental Data
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeExtension(Supplemental Data Extension) (Extension Type: Reference(Resource))
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      22. MeasureReport.extension:supplementalData.id
      Definition

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

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

      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

        Reference a criteria by specifying that criteria's unique id

        ShortCriteria reference
        Control0..1
        TypeExtension(Criteria Reference Extension) (Extension Type: string)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        28. MeasureReport.extension:supplementalData.extension:description
        Slice Namedescription
        Definition

        A description of the group, population, stratifier, or supplemental data definition on which it appears. This is typically a restatement of the description of the corresponding element in the Measure being reported, but may also include additional information gathered by the reporting process.

        ShortDescription of the supplemental data
        Control0..1
        TypeExtension(Measure Report Population Description) (Extension Type: markdown)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        30. MeasureReport.extension:supplementalData.url
        Definition

        Source of the definition for the extension code - a logical name or a URL.

        Shortidentifies the meaning of the extension
        Comments

        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

        Control1..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        Fixed Valuehttp://hl7.org/fhir/StructureDefinition/measurereport-supplementalData
        32. MeasureReport.extension:supplementalData.value[x]
        Definition

        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

        ShortFor supplementalData that is a calculation, this will be a reference to an Observation containing the result of the supplementalData calculation. For supplementalData that is a resource, this will be a reference to the supplementalData resource.
        Control0..1
        TypeReference(Resource)
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. MeasureReport.extension:scoring
        Slice Namescoring
        Definition

        An Extension

        Shortproportion | ratio | continuous-variable | cohort | composite
        Control0..1
        This element is affected by the following invariants: ele-1, deqm-2, deqm-3
        TypeExtension(DEQM Measure Scoring Extension) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        36. MeasureReport.extension:vendor
        Slice Namevendor
        Definition

        A reference to the vendor who queried the data, calculated results and/or generated the report.

        ShortVendor information
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(DEQM Reporting Vendor Extension) (Extension Type: Reference(QICore Organization))
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        38. MeasureReport.extension:cehrt
        Slice Namecehrt
        Definition

        An identifier that represents the EHR certication number (CERHT). See Certified EHR Technology For more information.

        ShortCMS EHR Certifciation ID
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(DEQM Certification Identifier Extension) (Extension Type: Identifier)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        40. MeasureReport.extension:cehrt.id
        Definition

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

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

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          Fixed Valuehttp://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-certificationIdentifier
          46. MeasureReport.extension:cehrt.value[x]
          Definition

          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

          ShortValue of extension
          Control1..1
          TypeIdentifier
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on MeasureReport.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
          • type @ $this
          • 48. MeasureReport.extension:cehrt.value[x]:valueIdentifier
            Slice NamevalueIdentifier
            Definition

            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

            ShortValue of extension
            Control1..1
            TypeIdentifier
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Pattern Value{
              "system" : "urn:oid:2.16.840.1.113883.3.2074.1"
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            50. MeasureReport.extension:software
            Slice Namesoftware
            Definition

            Specifies the software systems used in the packaging and testing of knowledge artifacts. Specifically to support explicitly stating which versions of the various software components were used in the authoring, packaging, and testing.

            ShortExtension
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(CRMI Software System) (Extension Type: Reference(CRMI Software System Device))
            Is Modifierfalse
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            52. MeasureReport.extension:location
            Slice Namelocation
            Definition

            Location from which reported data was gathered. This extension is used to provide the location(s) from which reported data was gathered in a MeasureReport, such as individual, summary and data exchange measure report.

            ShortLocation(s) from which reported data was gathered
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(DEQM Data Location Extension) (Extension Type: Reference(QICore Location))
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            54. MeasureReport.extension:message
            Slice Namemessage
            Definition

            An OperationOutcome resource with information, warning, or error messages that were generated as part of processing an operation.

            ShortEvaluation messages
            Control0..1
            TypeExtension(Messages) (Extension Type: Reference(OperationOutcome))
            Is Modifierfalse
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            56. MeasureReport.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

            A formal identifier that is used to identify this MeasureReport when it is represented in other formats or referenced in a specification, model, design or an instance.

            ShortAdditional identifier for the MeasureReport
            Comments

            Typically, this is used for identifiers that can go in an HL7 V3 II data type - e.g. to identify this {{title}} outside of FHIR, where the logical URL is not possible to use.

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

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

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

            The MeasureReport status. No data will be available until the MeasureReport status is complete.

            Shortcomplete | pending | error
            Comments

            This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

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

            The status of the measure report.

            Typecode
            Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            62. MeasureReport.type
            Definition

            The type of measure report. This may be an individual report, which provides the score for the measure for an individual member of the population; a subject-listing, which returns the list of members that meet the various criteria in the measure; a summary report, which returns a population count for each of the criteria in the measure; or a data-collection, which enables the MeasureReport to be used to exchange the data-of-interest for a quality measure.

            Shortindividual | subject-list | summary | data-collection
            Comments

            Data-collection reports are used only to communicate data-of-interest for a measure. They do not necessarily include all the data for a particular subject or population, but they may.

            Control1..1
            This element is affected by the following invariants: mrp-1
            BindingThe codes SHALL be taken from MeasureReportType
            (required to http://hl7.org/fhir/ValueSet/measure-report-type|4.0.1)

            The type of the measure report.

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

            A reference to the Measure that was calculated to produce this report.

            ShortWhat measure was calculated
            Control1..1
            Typecanonical(Measure)
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            66. MeasureReport.subject
            Definition

            Optional subject identifying the individual or individuals the report is for.

            ShortWhat individual(s) the report is for
            Control0..1
            TypeReference(Patient, Practitioner, PractitionerRole, Location, Device, RelatedPerson, Group)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            68. MeasureReport.date
            Definition

            The date this measure report was generated.

            ShortWhen the report was generated
            Control0..1
            TypedateTime
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            70. MeasureReport.reporter
            Definition

            The individual, location, or organization that is reporting the data.

            ShortWho is reporting the data
            Control0..1
            TypeReference(Practitioner, PractitionerRole, Location, Organization)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            72. MeasureReport.period
            Definition

            The reporting period for which the report was calculated.

            ShortWhat period the report covers
            Control1..1
            TypePeriod
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            74. MeasureReport.improvementNotation
            Definition

            Whether improvement in the measure is noted by an increase or decrease in the measure score.

            Shortincrease | decrease
            Comments

            This element is typically defined by the measure, but reproduced here to ensure the measure score can be interpreted. The element is labeled as a modifier because it changes the interpretation of the reported measure score.

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

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

            TypeCodeableConcept
            Is Modifiertrue because Improvement notation determines how to interpret the measure score (i.e. whether an increase is an improvement)
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            76. MeasureReport.group
            Definition

            The results of the calculation, one for each population group in the measure.

            ShortMeasure results for each group
            Control0..*
            This element is affected by the following invariants: mrp-1
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            78. MeasureReport.group.id
            Definition

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

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            80. MeasureReport.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.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

            The meaning of the population group as defined in the measure definition.

            ShortMeaning of the group
            Control0..1
            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            86. MeasureReport.group.population
            Definition

            The populations that make up the population group, one for each type of population appropriate for the measure.

            ShortThe populations in the group
            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            88. MeasureReport.group.population.id
            Definition

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

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

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

            The type of the population.

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

            The type of population (e.g. initial, numerator, denominator, etc.).

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            96. MeasureReport.group.population.count
            Definition

            The number of members of the population.

            ShortSize of the population
            Control0..1
            Typeinteger
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            98. MeasureReport.group.population.subjectResults
            Definition

            This element refers to a List of subject level MeasureReport resources, one for each subject in this population.

            ShortFor subject-list reports, the subject results in this population
            Control0..1
            TypeReference(List)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            100. MeasureReport.group.measureScore
            Definition

            The measure score for this population group, calculated as appropriate for the measure type and scoring method, and based on the contents of the populations defined in the group.

            ShortWhat score this group achieved
            Control0..1
            TypeQuantity
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            102. MeasureReport.group.stratifier
            Definition

            When a measure includes multiple stratifiers, there will be a stratifier group for each stratifier defined by the measure.

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

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

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

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

            The meaning of this stratifier, as defined in the measure definition.

            ShortWhat stratifier of the group
            Control0..*
            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            112. MeasureReport.group.stratifier.stratum
            Definition

            This element contains the results for a single stratum within the stratifier. For example, when stratifying on administrative gender, there will be four strata, one for each possible gender value.

            ShortStratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            114. MeasureReport.group.stratifier.stratum.id
            Definition

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

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

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

            The value for this stratum, expressed as a CodeableConcept. When defining stratifiers on complex values, the value must be rendered such that the value for each stratum within the stratifier is unique.

            ShortThe stratum value, e.g. male
            Control0..1
            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            122. MeasureReport.group.stratifier.stratum.component
            Definition

            A stratifier component value.

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

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

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

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

            The code for the stratum component value.

            ShortWhat stratifier component of the group
            Control1..1
            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            132. MeasureReport.group.stratifier.stratum.component.value
            Definition

            The stratum component value.

            ShortThe stratum component value, e.g. male
            Control1..1
            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            134. MeasureReport.group.stratifier.stratum.population
            Definition

            The populations that make up the stratum, one for each type of population appropriate to the measure.

            ShortPopulation results in this stratum
            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            136. MeasureReport.group.stratifier.stratum.population.id
            Definition

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

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

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

            The type of the population.

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

            The type of population (e.g. initial, numerator, denominator, etc.).

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

            The number of members of the population in this stratum.

            ShortSize of the population
            Control0..1
            Typeinteger
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            146. MeasureReport.group.stratifier.stratum.population.subjectResults
            Definition

            This element refers to a List of subject level MeasureReport resources, one for each subject in this population in this stratum.

            ShortFor subject-list reports, the subject results in this population
            Control0..1
            TypeReference(List)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            148. MeasureReport.group.stratifier.stratum.measureScore
            Definition

            The measure score for this stratum, calculated as appropriate for the measure type and scoring method, and based on only the members of this stratum.

            ShortWhat score this stratum achieved
            Control0..1
            TypeQuantity
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            150. MeasureReport.evaluatedResource
            Definition

            A reference to a Bundle containing the Resources that were used in the calculation of this measure.

            ShortWhat data was used to calculate the measure score
            Control0..*
            TypeReference(Resource)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            152. MeasureReport.evaluatedResource.id
            Definition

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

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

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

              Reference a criteria by specifying that criteria's unique id

              ShortCriteria reference
              Control0..*
              TypeExtension(Criteria Reference Extension) (Extension Type: string)
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              158. MeasureReport.evaluatedResource.reference
              Definition

              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

              ShortLiteral reference, Relative, internal or absolute URL
              Comments

              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

              Control0..1
              This element is affected by the following invariants: ref-1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              160. MeasureReport.evaluatedResource.type
              Definition

              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

              ShortType the reference refers to (e.g. "Patient")
              Comments

              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

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

              Aa resource (or, for logical models, the URI of the logical model).

              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              162. MeasureReport.evaluatedResource.identifier
              Definition

              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

              ShortLogical reference, when literal reference is not known
              Comments

              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..1
              TypeIdentifier
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              164. MeasureReport.evaluatedResource.display
              Definition

              Plain text narrative that identifies the resource in addition to the resource reference.

              ShortText alternative for the resource
              Comments

              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

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