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:message
Slice Namemessage
Control0..1
TypeExtension(Messages) (Extension Type: Reference(OperationOutcome))
Must Supporttrue
4. MeasureReport.extension:reportingProgram
Slice NamereportingProgram
Control0..1
TypeExtension(DEQM Reporting Program Extension) (Extension Type: Choice of: CodeableConcept, canonical(CQFM Publishable Manifest))
Must Supporttrue
6. MeasureReport.extension:inputParameters
Slice NameinputParameters
Control0..1
TypeExtension(Input parameters) (Extension Type: Reference(Parameters))
Must Supporttrue
8. MeasureReport.extension:supplementalData
Slice NamesupplementalData
Control0..*
TypeExtension(Supplemental Data Extension) (Extension Type: Reference(Resource))
Must Supporttrue
10. MeasureReport.extension:supplementalData.extension:criteriaReference
Slice NamecriteriaReference
Control0..1
TypeExtension(Criteria Reference Extension) (Extension Type: string)
Must Supporttrue
12. MeasureReport.extension:supplementalData.extension:supplementalDataPopulationDescription
Slice NamesupplementalDataPopulationDescription
ShortDescription of the supplemental data
Control0..1
TypeExtension(Measure Report Population Description) (Extension Type: markdown)
Must Supporttrue
14. 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
16. MeasureReport.extension:vendor
Slice Namevendor
Control0..1
TypeExtension(DEQM Reporting Vendor Extension) (Extension Type: Reference(QICore Organization))
Must Supporttrue
18. MeasureReport.extension:cehrt
Slice Namecehrt
ShortCMS EHR Certifciation ID
Control0..1
TypeExtension(DEQM Certification Identifier Extension) (Extension Type: Identifier)
Must Supporttrue
20. MeasureReport.extension:cehrt.valueIdentifier
Control1..1
TypeIdentifier
Must Supporttrue
Pattern Value{
  "system" : "urn:oid:2.16.840.1.113883.3.2074.1"
}
22. MeasureReport.extension:software
Slice Namesoftware
Control0..*
TypeExtension(CRMI Software System) (Extension Type: Reference(CRMI Software System Device))
Must Supporttrue
24. MeasureReport.extension:location
Slice Namelocation
Control0..*
TypeExtension(DEQM Data Location Extension) (Extension Type: Reference(QICore Location))
26. MeasureReport.status
Must Supporttrue
28. 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
30. 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.

32. MeasureReport.subject
Control1..1
TypeReference(QICore Patient, QICore Practitioner, QICore PractitionerRole, QICore Location, QICore Device, QICore RelatedPerson)
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
34. 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
36. MeasureReport.reporter
Definition

Organization that generated the MeasureReport

ShortOrganization that generated the MeasureReport
Control1..1
TypeReference(QICore Organization)
Must Supporttrue
38. MeasureReport.reporter.extension:group
Slice Namegroup
Control0..1
TypeExtension(DEQM Reporter Group Extension) (Extension Type: Reference(Group))
Must Supporttrue
40. 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)
42. MeasureReport.period.start
Control1..1
Must Supporttrue
44. MeasureReport.period.end
Control1..1
Must Supporttrue
46. MeasureReport.improvementNotation
Control0..1
This element is affected by the following invariants: deqm-2
Must Supporttrue
48. 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())
50. MeasureReport.group.id
Must Supporttrue
52. 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
54. MeasureReport.group.extension:calculatedDate
Slice NamecalculatedDate
Control0..1
TypeExtension(DEQM Calculated Date Extension) (Extension Type: dateTime)
Must Supporttrue
56. 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
58. MeasureReport.group.extension:groupPopulationDescription
Slice NamegroupPopulationDescription
ShortDescription of the group
Control0..1
TypeExtension(Measure Report Population Description) (Extension Type: markdown)
Must Supporttrue
60. 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
62. 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
64. 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
66. MeasureReport.group.code
Must Supporttrue
68. 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())
70. 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
72. MeasureReport.group.population.extension:groupPopulationPopulationDescription
Slice NamegroupPopulationPopulationDescription
ShortDescription of the population
Control0..1
TypeExtension(Measure Report Population Description) (Extension Type: markdown)
Must Supporttrue
74. MeasureReport.group.population.code
Control1..1
Must Supporttrue
76. MeasureReport.group.population.count
Control0..1
This element is affected by the following invariants: deqm-8
Must Supporttrue
78. MeasureReport.group.population.subjectResults
Control0..0
Must Supportfalse
80. 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
82. 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
84. MeasureReport.group.stratifier
86. MeasureReport.group.stratifier.extension:stratifierPopulationDescription
Slice NamestratifierPopulationDescription
ShortDescription of the stratifier
Control0..1
TypeExtension(Measure Report Population Description) (Extension Type: markdown)
Must Supporttrue
88. 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
90. MeasureReport.group.stratifier.stratum
Must Supporttrue
92. 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())
94. MeasureReport.group.stratifier.stratum.population.extension:stratumPopulationDescription
Slice NamestratumPopulationDescription
Control0..1
This element is affected by the following invariants: deqm-9
TypeExtension(Count Quantity) (Extension Type: Quantity)
Must Supporttrue
96. MeasureReport.group.stratifier.stratum.population.code
Control1..1
Must Supporttrue
98. MeasureReport.group.stratifier.stratum.population.count
Control1..1
This element is affected by the following invariants: deqm-9
Must Supporttrue
100. MeasureReport.evaluatedResource
Must Supporttrue
Requirements

To support the reporting of supplemental data elements.

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: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())
6. 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())
8. 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())
10. 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())
12. 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())
14. MeasureReport.extension:supplementalData.extension:supplementalDataPopulationDescription
Slice NamesupplementalDataPopulationDescription
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())
16. 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
18. 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())
20. 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())
22. 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())
24. 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
26. 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
  • 28. 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()))
    30. 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())
    32. 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())
    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
    Must Supporttrue
    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
    Must Supporttrue
    Summarytrue
    Requirements

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

    Fixed Valueindividual
    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(CRMI Shareable Measure, Measure)
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

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

    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
    Control10..1
    TypeReference(QICore Patient, QICore Practitioner, QICore PractitionerRole, QICore Location, QICore Device, QICore RelatedPerson, Patient, Practitioner, PractitionerRole, Location, Device, RelatedPerson, Group)
    Is Modifierfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    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. Note: The language in R5 was changed to calculated. We are clarifying that intent.
    Control10..1
    TypedateTime
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    46. MeasureReport.reporter
    Definition

    Organization that generated the MeasureReport


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

    ShortOrganization that generated the MeasureReportWho is reporting the data
    Control10..1
    TypeReference(QICore Organization, Practitioner, PractitionerRole, Location, Organization)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    48. MeasureReport.reporter.extension:group
    Slice Namegroup
    Definition

    Group of practitioners responsible for a report. This extension is used to provide the capability to allow the participating practitioners to be documented.

    ShortGroup of practitioners responsible for a report
    Control0..1
    TypeExtension(DEQM Reporter Group Extension) (Extension Type: Reference(Group))
    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())
    50. MeasureReport.period
    Definition

    The reporting period for which the report was calculated.

    ShortThe period for which the report was calculated. For the gaps in care use case, this is referred to as the gaps through period.What period the report covers
    Control1..1
    This element is affected by the following invariants: deqm-1
    TypePeriod
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    deqm-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) (start.toString().length()>9 and end.toString().length()>9)
    52. MeasureReport.period.start
    Definition

    The start of the period. The boundary is inclusive.

    ShortStarting time with inclusive boundary
    Comments

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

    Control10..1
    This element is affected by the following invariants: per-1
    TypedateTime
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    54. MeasureReport.period.end
    Definition

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

    ShortEnd time with inclusive boundary, if not ongoing
    Comments

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

    Control10..1
    This element is affected by the following invariants: per-1
    TypedateTime
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    56. 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
    This element is affected by the following invariants: deqm-2
    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)
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    58. 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
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    deqm-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())
    60. 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
    Must Supporttrue
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    62. MeasureReport.group.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-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())
    64. MeasureReport.group.extension:calculatedDate
    Slice NamecalculatedDate
    Definition

    This applies to the date this metric was actually calculated. If your measure calculation draws on stored calculations and there are multiple calculation dates, this extension would not apply, as in the example of a composite measure where the individual measures were calculated on different dates. This would only cover the case where there is only one calculation date.

    ShortThe date the score was calculated
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(DEQM Calculated Date Extension) (Extension Type: dateTime)
    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())
    66. MeasureReport.group.extension:groupImprovementNotation
    Slice NamegroupImprovementNotation
    Definition

    An Extension

    Shortincrease | decrease
    Control0..1
    This element is affected by the following invariants: ele-1, deqm-4
    TypeExtension(DEQM Group Improvement Notation 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())
    68. MeasureReport.group.extension:groupPopulationDescription
    Slice NamegroupPopulationDescription
    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 group
    Control0..1
    TypeExtension(Measure Report Population Description) (Extension Type: markdown)
    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())
    70. MeasureReport.group.extension:numeratorMembership
    Slice NamenumeratorMembership
    Definition

    The numerator population membership is the number of subjects in the numerator after exceptions and exclusions.

    ShortProvides the number of subjects in the numerator population membership.
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Numerator Membership) (Extension Type: Quantity)
    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())
    72. MeasureReport.group.extension:denominatorMembership
    Slice NamedenominatorMembership
    Definition

    The denominator population membership is the number of subjects in the denominator after exceptions and exclusions.

    ShortProvides the number of subjects in the denominator population membership.
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Denominator Membership) (Extension Type: Quantity)
    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())
    74. MeasureReport.group.extension:measurePopulationMembership
    Slice NamemeasurePopulationMembership
    Definition

    The measure population membership is the number of subjects in the measure population after exclusions.

    ShortProvides the number of subjects in the measure population membership.
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Measure Population Membership) (Extension Type: Quantity)
    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())
    76. 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())
    78. 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
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    80. 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..*
    This element is affected by the following invariants: deqm-5
    TypeBackboneElement
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    deqm-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())
    82. 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)
    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())
    84. MeasureReport.group.population.extension:groupPopulationPopulationDescription
    Slice NamegroupPopulationPopulationDescription
    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 population
    Control0..1
    TypeExtension(Measure Report Population Description) (Extension Type: markdown)
    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())
    86. 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())
    88. 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
    Control10..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
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    90. MeasureReport.group.population.count
    Definition

    The number of members of the population.

    ShortSize of the population
    Control0..1
    This element is affected by the following invariants: deqm-8
    Typeinteger
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    92. 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..01
    TypeReference(List)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    94. 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
    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
    TypeQuantity
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    96. MeasureReport.group.measureScore.extension:altscoretype
    Slice Namealtscoretype
    Definition

    Possible value types for the measureScore elements in addition to the standard Quantity type. The alternate type is determined by the Quality Measure Aggregate Method extension used on the Measure. The reported type of the measureScore for continuous variable measures is determined by the result type of the aggregate method operation.

    ShortPossible additional measureScore value types
    Comments

    This extension corresponds to the additional MeasureScore type added to the R5 version of MeasureReport.

    Control0..1
    TypeExtension(DEQM Alternate Score Type Extension) (Extension Type: Choice of: dateTime, CodeableConcept, Period, Range, Duration, boolean)
    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())
    98. MeasureReport.group.measureScore.comparator
    Definition

    How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

    Short< | <= | >= | > - how to understand the value
    Control0..1
    BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
    (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

    How the Quantity should be understood and represented.

    Typecode
    Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

    Meaning if MissingIf there is no comparator, then there is no modification of the value
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    100. 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()))
    102. MeasureReport.group.stratifier.extension:stratifierPopulationDescription
    Slice NamestratifierPopulationDescription
    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 stratifier
    Control0..1
    TypeExtension(Measure Report Population Description) (Extension Type: markdown)
    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())
    104. 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())
    106. 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
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    108. 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
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    110. 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())
    112. 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
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    deqm-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())
    114. MeasureReport.group.stratifier.stratum.population.extension:stratumPopulationDescription
    Slice NamestratumPopulationDescription
    Definition

    A Quantity representing the size of the population. This is important to support the case when a population value may result in a decimal when reporting composite measures.

    ShortSize of the population as a quantity.
    Control0..1
    This element is affected by the following invariants: deqm-9
    TypeExtension(Count Quantity) (Extension Type: Quantity)
    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())
    116. 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())
    118. 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
    Control10..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
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    120. MeasureReport.group.stratifier.stratum.population.count
    Definition

    The number of members of the population in this stratum.

    ShortSize of the population
    Control10..1
    This element is affected by the following invariants: deqm-9
    Typeinteger
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    122. 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
    Must Supporttrue
    Summaryfalse
    Requirements

    To support the reporting of supplemental data elements.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    124. 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: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())
      18. 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())
      20. 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())
      22. 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())
      24. 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
      26. 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
      • 28. 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())
        30. MeasureReport.extension:supplementalData.extension:supplementalDataPopulationDescription
        Slice NamesupplementalDataPopulationDescription
        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())
        32. 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
        34. 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()))
        36. 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())
        38. 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())
        40. 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())
        42. 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
        44. 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
        • 46. 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
          48. 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
          • 50. 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()))
            52. 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())
            54. 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())
            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
            Must Supporttrue
            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
            Must Supporttrue
            Summarytrue
            Requirements

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

            Fixed Valueindividual
            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(CRMI Shareable Measure)
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Requirements

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

            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
            Control1..1
            TypeReference(QICore Patient, QICore Practitioner, QICore PractitionerRole, QICore Location, QICore Device, QICore RelatedPerson)
            Is Modifierfalse
            Must Supporttrue
            Must Support TypesNo must-support rules about the choice of types/profiles
            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. Note: The language in R5 was changed to calculated. We are clarifying that intent.
            Control1..1
            TypedateTime
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            70. MeasureReport.reporter
            Definition

            Organization that generated the MeasureReport

            ShortOrganization that generated the MeasureReport
            Control1..1
            TypeReference(QICore Organization)
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            72. MeasureReport.reporter.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
            74. MeasureReport.reporter.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.reporter.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 76. MeasureReport.reporter.extension:group
              Slice Namegroup
              Definition

              Group of practitioners responsible for a report. This extension is used to provide the capability to allow the participating practitioners to be documented.

              ShortGroup of practitioners responsible for a report
              Control0..1
              TypeExtension(DEQM Reporter Group Extension) (Extension Type: Reference(Group))
              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())
              78. MeasureReport.reporter.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()))
              80. MeasureReport.reporter.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()))
              82. MeasureReport.reporter.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()))
              84. MeasureReport.reporter.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()))
              86. MeasureReport.period
              Definition

              The reporting period for which the report was calculated.

              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
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              deqm-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) (start.toString().length()>9 and end.toString().length()>9)
              88. MeasureReport.period.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.period.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.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 92. MeasureReport.period.start
                Definition

                The start of the period. The boundary is inclusive.

                ShortStarting time with inclusive boundary
                Comments

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

                Control1..1
                This element is affected by the following invariants: per-1
                TypedateTime
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                94. MeasureReport.period.end
                Definition

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

                ShortEnd time with inclusive boundary, if not ongoing
                Comments

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

                Control1..1
                This element is affected by the following invariants: per-1
                TypedateTime
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                96. 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
                This element is affected by the following invariants: deqm-2
                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)
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                98. 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
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                deqm-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())
                100. 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
                Must Supporttrue
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                102. MeasureReport.group.extension
                Definition

                An Extension

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

                  This applies to the date this metric was actually calculated. If your measure calculation draws on stored calculations and there are multiple calculation dates, this extension would not apply, as in the example of a composite measure where the individual measures were calculated on different dates. This would only cover the case where there is only one calculation date.

                  ShortThe date the score was calculated
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(DEQM Calculated Date Extension) (Extension Type: dateTime)
                  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())
                  108. MeasureReport.group.extension:groupImprovementNotation
                  Slice NamegroupImprovementNotation
                  Definition

                  An Extension

                  Shortincrease | decrease
                  Control0..1
                  This element is affected by the following invariants: ele-1, deqm-4
                  TypeExtension(DEQM Group Improvement Notation 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())
                  110. MeasureReport.group.extension:groupPopulationDescription
                  Slice NamegroupPopulationDescription
                  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 group
                  Control0..1
                  TypeExtension(Measure Report Population Description) (Extension Type: markdown)
                  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())
                  112. MeasureReport.group.extension:numeratorMembership
                  Slice NamenumeratorMembership
                  Definition

                  The numerator population membership is the number of subjects in the numerator after exceptions and exclusions.

                  ShortProvides the number of subjects in the numerator population membership.
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Numerator Membership) (Extension Type: Quantity)
                  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())
                  114. MeasureReport.group.extension:denominatorMembership
                  Slice NamedenominatorMembership
                  Definition

                  The denominator population membership is the number of subjects in the denominator after exceptions and exclusions.

                  ShortProvides the number of subjects in the denominator population membership.
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Denominator Membership) (Extension Type: Quantity)
                  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())
                  116. MeasureReport.group.extension:measurePopulationMembership
                  Slice NamemeasurePopulationMembership
                  Definition

                  The measure population membership is the number of subjects in the measure population after exclusions.

                  ShortProvides the number of subjects in the measure population membership.
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Measure Population Membership) (Extension Type: Quantity)
                  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())
                  118. 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())
                  120. 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
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  122. 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..*
                  This element is affected by the following invariants: deqm-5
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  deqm-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())
                  124. 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
                  126. MeasureReport.group.population.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.group.population.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 128. 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)
                    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())
                    130. MeasureReport.group.population.extension:groupPopulationPopulationDescription
                    Slice NamegroupPopulationPopulationDescription
                    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 population
                    Control0..1
                    TypeExtension(Measure Report Population Description) (Extension Type: markdown)
                    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())
                    132. 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())
                    134. 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
                    Control1..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
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    136. MeasureReport.group.population.count
                    Definition

                    The number of members of the population.

                    ShortSize of the population
                    Control0..1
                    This element is affected by the following invariants: deqm-8
                    Typeinteger
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    138. 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..0
                    TypeReference(List)
                    Is Modifierfalse
                    Must Supportfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    140. 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
                    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
                    TypeQuantity
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    142. MeasureReport.group.measureScore.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
                    144. MeasureReport.group.measureScore.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.group.measureScore.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 146. MeasureReport.group.measureScore.extension:altscoretype
                      Slice Namealtscoretype
                      Definition

                      Possible value types for the measureScore elements in addition to the standard Quantity type. The alternate type is determined by the Quality Measure Aggregate Method extension used on the Measure. The reported type of the measureScore for continuous variable measures is determined by the result type of the aggregate method operation.

                      ShortPossible additional measureScore value types
                      Comments

                      This extension corresponds to the additional MeasureScore type added to the R5 version of MeasureReport.

                      Control0..1
                      TypeExtension(DEQM Alternate Score Type Extension) (Extension Type: Choice of: dateTime, CodeableConcept, Period, Range, Duration, boolean)
                      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())
                      148. MeasureReport.group.measureScore.value
                      Definition

                      The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                      ShortNumerical value (with implicit precision)
                      Comments

                      The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

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

                      Precision is handled implicitly in almost all cases of measurement.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      150. MeasureReport.group.measureScore.comparator
                      Definition

                      How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                      Short< | <= | >= | > - how to understand the value
                      Control0..1
                      BindingThe codes SHALL be taken from QuantityComparator
                      (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                      How the Quantity should be understood and represented.

                      Typecode
                      Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                      Meaning if MissingIf there is no comparator, then there is no modification of the value
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      152. MeasureReport.group.measureScore.unit
                      Definition

                      A human-readable form of the unit.

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

                      There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      154. MeasureReport.group.measureScore.system
                      Definition

                      The identification of the system that provides the coded form of the unit.

                      ShortSystem that defines coded unit form
                      Control0..1
                      This element is affected by the following invariants: qty-3
                      Typeuri
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Need to know the system that defines the coded form of the unit.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      156. MeasureReport.group.measureScore.code
                      Definition

                      A computer processable form of the unit in some unit representation system.

                      ShortCoded form of the unit
                      Comments

                      The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

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

                      Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      158. 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()))
                      160. 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
                      162. MeasureReport.group.stratifier.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.group.stratifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 164. MeasureReport.group.stratifier.extension:stratifierPopulationDescription
                        Slice NamestratifierPopulationDescription
                        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 stratifier
                        Control0..1
                        TypeExtension(Measure Report Population Description) (Extension Type: markdown)
                        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())
                        166. 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())
                        168. 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
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        170. 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
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        172. 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
                        174. 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())
                        176. 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())
                        178. 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()))
                        180. 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()))
                        182. 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
                        184. 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())
                        186. 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())
                        188. 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()))
                        190. 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()))
                        192. 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
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        deqm-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())
                        194. 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
                        196. MeasureReport.group.stratifier.stratum.population.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.group.stratifier.stratum.population.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 198. MeasureReport.group.stratifier.stratum.population.extension:stratumPopulationDescription
                          Slice NamestratumPopulationDescription
                          Definition

                          A Quantity representing the size of the population. This is important to support the case when a population value may result in a decimal when reporting composite measures.

                          ShortSize of the population as a quantity.
                          Control0..1
                          This element is affected by the following invariants: deqm-9
                          TypeExtension(Count Quantity) (Extension Type: Quantity)
                          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())
                          200. 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())
                          202. 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
                          Control1..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
                          Must Supporttrue
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          204. MeasureReport.group.stratifier.stratum.population.count
                          Definition

                          The number of members of the population in this stratum.

                          ShortSize of the population
                          Control1..1
                          This element is affected by the following invariants: deqm-9
                          Typeinteger
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          206. 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()))
                          208. 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()))
                          210. 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
                          Must Supporttrue
                          Summaryfalse
                          Requirements

                          To support the reporting of supplemental data elements.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          212. 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
                          214. 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
                          • 216. 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())
                            218. 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()))
                            220. 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()))
                            222. 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()))
                            224. 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()))