Da Vinci Risk Adjustment Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 2.0.0-preview built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-ra/ and changes regularly. See the Directory of published versions
Official URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-datax-measurereport | Version: 2.0.0-preview | |||
Active as of 2024-11-04 | Computable Name: RiskAdjustmentDataExchangeMeasureReport | |||
Copyright/Legal: Used by permission of HL7 International - Clinical Quality Information Work Group, all rights reserved Creative Commons License |
This profile is based on the MeasureReport. It is used for Provider to submit data such as clinical evaluation evidence to Payer.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from MeasureReport
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
MeasureReport | 0..* | MeasureReport | This is a risk adjustment data exchange MeasureReport. | |
Slices for extension | Content/Rules for all slices | |||
measurereport-category | S | 1..1 | (Complex) | What category is this measure report URL: http://hl7.org/fhir/StructureDefinition/measurereport-category |
value[x] | ||||
coding | 1..1 | Coding | Code defined by a terminology system | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: ra | |
payerCodingGapReportId | S | 0..1 | id | Payer generated coding gap report id URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-payerCodingGapReportId |
software | S | 0..* | Reference(CRMI Software System Device) | Extension URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem |
vendor | S | 0..1 | Reference(US Core Organization Profile) | Vendor information URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-reportingVendor |
status | S | 1..1 | code | complete | pending | error |
type | S | 1..1 | code | The type code is fixed to 'data-collection' for a risk adjustment data exchange measure report Fixed Value: data-collection |
measure | S | 1..1 | canonical(Risk Adjustment Model Measure) | This references a measure that represents a risk adjustment model, such as CMS-HCC V24, CMS-HCC V28. |
subject | S | 1..1 | Reference(US Core Patient Profile) | What individual(s) the report is for |
date | S | 1..1 | dateTime | When the report was generated |
reporter | S | 1..1 | Reference(US Core Organization Profile) | Organization that generated the MeasureReport |
period | SC | 1..1 | Period | Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) |
start | S | 1..1 | dateTime | Starting time with inclusive boundary |
end | S | 1..1 | dateTime | End time with inclusive boundary, if not ongoing |
group | S | 0..* | BackboneElement | Condition Category |
id | S | 1..1 | string | Unique id for inter-element referencing |
code | S | 0..1 | CodeableConcept | Condition Category (CC) code for a Risk Adjustment Model Binding: Sample CMS Hierarchical Condition Category (example) |
evaluatedResource | S | 0..* | Reference(Resource) | An evaluated resource in a risk adjusstment data exchange MeasureReport is any data Provider submits to Payer as clinical evaluation evidence, such as a Consolidated Clinical Document Architecture (C-CDA) document, enounters, and diagnoses. |
Slices for extension | Content/Rules for all slices | |||
groupReference | S | 0..* | string | This references the MeasureReport.group.id. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference |
Documentation for this format |
Path | Conformance | ValueSet | URI |
MeasureReport.group.code | example | SampleCMSHCChttp://hl7.org/fhir/us/davinci-ra/ValueSet/sample-cmshcc from this IG |
Id | Grade | Path(s) | Details | Requirements |
ra-1 | error | MeasureReport.period | Date precision SHALL be at least to day ( YYYY-MM-DD ) : start.toString().length()>9 and end.toString().length()>9 |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
MeasureReport | C | 0..* | MeasureReport | This is a risk adjustment data exchange MeasureReport. mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |
measurereport-category | S | 1..1 | (Complex) | What category is this measure report URL: http://hl7.org/fhir/StructureDefinition/measurereport-category |
url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/measurereport-category" | |
value[x] | 1..1 | CodeableConcept | Value of extension Binding: MeasureReportCategory (extensible) | |
coding | Σ | 1..1 | Coding | Code defined by a terminology system |
code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: ra |
payerCodingGapReportId | S | 0..1 | id | Payer generated coding gap report id URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-payerCodingGapReportId |
software | S | 0..* | Reference(CRMI Software System Device) | Extension URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem |
vendor | S | 0..1 | Reference(US Core Organization Profile) | Vendor information URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-reportingVendor |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
status | ?!SΣ | 1..1 | code | complete | pending | error Binding: MeasureReportStatus (required): The status of the measure report. |
type | SΣC | 1..1 | code | The type code is fixed to 'data-collection' for a risk adjustment data exchange measure report Binding: MeasureReportType (required): The type of the measure report. Fixed Value: data-collection |
measure | SΣ | 1..1 | canonical(Risk Adjustment Model Measure) | This references a measure that represents a risk adjustment model, such as CMS-HCC V24, CMS-HCC V28. |
subject | SΣ | 1..1 | Reference(US Core Patient Profile) | What individual(s) the report is for |
date | SΣ | 1..1 | dateTime | When the report was generated |
reporter | SΣ | 1..1 | Reference(US Core Organization Profile) | Organization that generated the MeasureReport |
period | SΣC | 1..1 | Period | Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) |
start | SΣC | 1..1 | dateTime | Starting time with inclusive boundary |
end | SΣC | 1..1 | dateTime | End time with inclusive boundary, if not ongoing |
improvementNotation | ?!Σ | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue. |
group | SC | 0..* | BackboneElement | Condition Category |
id | S | 1..1 | string | Unique id for inter-element referencing |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
code | SΣ | 0..1 | CodeableConcept | Condition Category (CC) code for a Risk Adjustment Model Binding: Sample CMS Hierarchical Condition Category (example) |
evaluatedResource | S | 0..* | Reference(Resource) | An evaluated resource in a risk adjusstment data exchange MeasureReport is any data Provider submits to Payer as clinical evaluation evidence, such as a Consolidated Clinical Document Architecture (C-CDA) document, enounters, and diagnoses. |
Slices for extension | Content/Rules for all slices | |||
groupReference | S | 0..* | string | This references the MeasureReport.group.id. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference |
Documentation for this format |
Path | Conformance | ValueSet / Code | URI |
MeasureReport.extension:measurereport-category.value[x] | extensible | MeasureReportCategoryhttp://hl7.org/fhir/ValueSet/measurereport-category | |
MeasureReport.status | required | MeasureReportStatushttp://hl7.org/fhir/ValueSet/measure-report-status|4.0.1 from the FHIR Standard | |
MeasureReport.type | required | Fixed Value: data-collectionhttp://hl7.org/fhir/ValueSet/measure-report-type|4.0.1 from the FHIR Standard | |
MeasureReport.improvementNotation | required | MeasureImprovementNotationhttp://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.1 from the FHIR Standard | |
MeasureReport.group.code | example | SampleCMSHCChttp://hl7.org/fhir/us/davinci-ra/ValueSet/sample-cmshcc from this IG |
Id | Grade | Path(s) | Details | Requirements |
dom-2 | error | MeasureReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
dom-3 | error | MeasureReport | 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 | error | MeasureReport | 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 | error | MeasureReport | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
dom-6 | best practice | MeasureReport | A resource should have narrative for robust management : text.`div`.exists() | |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
mrp-1 | error | MeasureReport | Measure Reports used for data collection SHALL NOT communicate group and score information : (type != 'data-collection') or group.exists().not() | |
mrp-2 | error | MeasureReport | Stratifiers SHALL be either a single criteria or a set of criteria components : group.stratifier.stratum.all(value.exists() xor component.exists()) | |
ra-1 | error | MeasureReport.period | Date precision SHALL be at least to day ( YYYY-MM-DD ) : start.toString().length()>9 and end.toString().length()>9 |
Name | Flags | Card. | Type | Description & Constraints | ||||
---|---|---|---|---|---|---|---|---|
MeasureReport | C | 0..* | MeasureReport | This is a risk adjustment data exchange MeasureReport. mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components | ||||
id | Σ | 0..1 | id | Logical id of this artifact | ||||
meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
contained | 0..* | Resource | Contained, inline Resources | |||||
Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
measurereport-category | S | 1..1 | (Complex) | What category is this measure report URL: http://hl7.org/fhir/StructureDefinition/measurereport-category | ||||
id | 0..1 | id | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/measurereport-category" | |||||
value[x] | 1..1 | CodeableConcept | Value of extension Binding: MeasureReportCategory (extensible) | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
coding | Σ | 1..1 | Coding | Code defined by a terminology system | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
system | Σ | 0..1 | uri | Identity of the terminology system | ||||
version | Σ | 0..1 | string | Version of the system - if relevant | ||||
code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: ra | ||||
display | Σ | 0..1 | string | Representation defined by the system | ||||
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
text | Σ | 0..1 | string | Plain text representation of the concept | ||||
payerCodingGapReportId | S | 0..1 | id | Payer generated coding gap report id URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-payerCodingGapReportId | ||||
software | S | 0..* | Reference(CRMI Software System Device) | Extension URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem | ||||
vendor | S | 0..1 | Reference(US Core Organization Profile) | Vendor information URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-reportingVendor | ||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
identifier | Σ | 0..* | Identifier | Additional identifier for the MeasureReport | ||||
status | ?!SΣ | 1..1 | code | complete | pending | error Binding: MeasureReportStatus (required): The status of the measure report. | ||||
type | SΣC | 1..1 | code | The type code is fixed to 'data-collection' for a risk adjustment data exchange measure report Binding: MeasureReportType (required): The type of the measure report. Fixed Value: data-collection | ||||
measure | SΣ | 1..1 | canonical(Risk Adjustment Model Measure) | This references a measure that represents a risk adjustment model, such as CMS-HCC V24, CMS-HCC V28. | ||||
subject | SΣ | 1..1 | Reference(US Core Patient Profile) | What individual(s) the report is for | ||||
date | SΣ | 1..1 | dateTime | When the report was generated | ||||
reporter | SΣ | 1..1 | Reference(US Core Organization Profile) | Organization that generated the MeasureReport | ||||
period | SΣC | 1..1 | Period | Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
start | SΣC | 1..1 | dateTime | Starting time with inclusive boundary | ||||
end | SΣC | 1..1 | dateTime | End time with inclusive boundary, if not ongoing | ||||
improvementNotation | ?!Σ | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue. | ||||
group | SC | 0..* | BackboneElement | Condition Category | ||||
id | S | 1..1 | string | Unique id for inter-element referencing | ||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
code | SΣ | 0..1 | CodeableConcept | Condition Category (CC) code for a Risk Adjustment Model Binding: Sample CMS Hierarchical Condition Category (example) | ||||
population | 0..* | BackboneElement | The populations in the group | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
code | Σ | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.). | ||||
count | 0..1 | integer | Size of the population | |||||
subjectResults | 0..1 | Reference(List) | For subject-list reports, the subject results in this population | |||||
measureScore | Σ | 0..1 | Quantity | What score this group achieved | ||||
stratifier | 0..* | BackboneElement | Stratification results | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
code | 0..* | CodeableConcept | What stratifier of the group | |||||
stratum | 0..* | BackboneElement | Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
value | 0..1 | CodeableConcept | The stratum value, e.g. male | |||||
component | 0..* | BackboneElement | Stratifier component values | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
code | 1..1 | CodeableConcept | What stratifier component of the group | |||||
value | 1..1 | CodeableConcept | The stratum component value, e.g. male | |||||
population | 0..* | BackboneElement | Population results in this stratum | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
code | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.). | |||||
count | 0..1 | integer | Size of the population | |||||
subjectResults | 0..1 | Reference(List) | For subject-list reports, the subject results in this population | |||||
measureScore | 0..1 | Quantity | What score this stratum achieved | |||||
evaluatedResource | S | 0..* | Reference(Resource) | An evaluated resource in a risk adjusstment data exchange MeasureReport is any data Provider submits to Payer as clinical evaluation evidence, such as a Consolidated Clinical Document Architecture (C-CDA) document, enounters, and diagnoses. | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
groupReference | S | 0..* | string | This references the MeasureReport.group.id. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference | ||||
reference | ΣC | 0..1 | string | Literal reference, Relative, internal or absolute URL | ||||
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | ||||
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | ||||
display | Σ | 0..1 | string | Text alternative for the resource | ||||
Documentation for this format |
Path | Conformance | ValueSet / Code | URI | |||
MeasureReport.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languages from the FHIR Standard | ||||
MeasureReport.extension:measurereport-category.value[x] | extensible | MeasureReportCategoryhttp://hl7.org/fhir/ValueSet/measurereport-category | ||||
MeasureReport.status | required | MeasureReportStatushttp://hl7.org/fhir/ValueSet/measure-report-status|4.0.1 from the FHIR Standard | ||||
MeasureReport.type | required | Fixed Value: data-collectionhttp://hl7.org/fhir/ValueSet/measure-report-type|4.0.1 from the FHIR Standard | ||||
MeasureReport.improvementNotation | required | MeasureImprovementNotationhttp://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.1 from the FHIR Standard | ||||
MeasureReport.group.code | example | SampleCMSHCChttp://hl7.org/fhir/us/davinci-ra/ValueSet/sample-cmshcc from this IG | ||||
MeasureReport.group.population.code | extensible | MeasurePopulationTypehttp://hl7.org/fhir/ValueSet/measure-population from the FHIR Standard | ||||
MeasureReport.group.stratifier.stratum.population.code | extensible | MeasurePopulationTypehttp://hl7.org/fhir/ValueSet/measure-population from the FHIR Standard | ||||
MeasureReport.evaluatedResource.type | extensible | ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard |
Id | Grade | Path(s) | Details | Requirements |
dom-2 | error | MeasureReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
dom-3 | error | MeasureReport | 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 | error | MeasureReport | 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 | error | MeasureReport | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
dom-6 | best practice | MeasureReport | A resource should have narrative for robust management : text.`div`.exists() | |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
mrp-1 | error | MeasureReport | Measure Reports used for data collection SHALL NOT communicate group and score information : (type != 'data-collection') or group.exists().not() | |
mrp-2 | error | MeasureReport | Stratifiers SHALL be either a single criteria or a set of criteria components : group.stratifier.stratum.all(value.exists() xor component.exists()) | |
ra-1 | error | MeasureReport.period | Date precision SHALL be at least to day ( YYYY-MM-DD ) : start.toString().length()>9 and end.toString().length()>9 |
This structure is derived from MeasureReport
Summary
Mandatory: 9 elements(1 nested mandatory element)
Must-Support: 18 elements
Fixed: 2 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Differential View
This structure is derived from MeasureReport
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
MeasureReport | 0..* | MeasureReport | This is a risk adjustment data exchange MeasureReport. | |
Slices for extension | Content/Rules for all slices | |||
measurereport-category | S | 1..1 | (Complex) | What category is this measure report URL: http://hl7.org/fhir/StructureDefinition/measurereport-category |
value[x] | ||||
coding | 1..1 | Coding | Code defined by a terminology system | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: ra | |
payerCodingGapReportId | S | 0..1 | id | Payer generated coding gap report id URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-payerCodingGapReportId |
software | S | 0..* | Reference(CRMI Software System Device) | Extension URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem |
vendor | S | 0..1 | Reference(US Core Organization Profile) | Vendor information URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-reportingVendor |
status | S | 1..1 | code | complete | pending | error |
type | S | 1..1 | code | The type code is fixed to 'data-collection' for a risk adjustment data exchange measure report Fixed Value: data-collection |
measure | S | 1..1 | canonical(Risk Adjustment Model Measure) | This references a measure that represents a risk adjustment model, such as CMS-HCC V24, CMS-HCC V28. |
subject | S | 1..1 | Reference(US Core Patient Profile) | What individual(s) the report is for |
date | S | 1..1 | dateTime | When the report was generated |
reporter | S | 1..1 | Reference(US Core Organization Profile) | Organization that generated the MeasureReport |
period | SC | 1..1 | Period | Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) |
start | S | 1..1 | dateTime | Starting time with inclusive boundary |
end | S | 1..1 | dateTime | End time with inclusive boundary, if not ongoing |
group | S | 0..* | BackboneElement | Condition Category |
id | S | 1..1 | string | Unique id for inter-element referencing |
code | S | 0..1 | CodeableConcept | Condition Category (CC) code for a Risk Adjustment Model Binding: Sample CMS Hierarchical Condition Category (example) |
evaluatedResource | S | 0..* | Reference(Resource) | An evaluated resource in a risk adjusstment data exchange MeasureReport is any data Provider submits to Payer as clinical evaluation evidence, such as a Consolidated Clinical Document Architecture (C-CDA) document, enounters, and diagnoses. |
Slices for extension | Content/Rules for all slices | |||
groupReference | S | 0..* | string | This references the MeasureReport.group.id. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference |
Documentation for this format |
Path | Conformance | ValueSet | URI |
MeasureReport.group.code | example | SampleCMSHCChttp://hl7.org/fhir/us/davinci-ra/ValueSet/sample-cmshcc from this IG |
Id | Grade | Path(s) | Details | Requirements |
ra-1 | error | MeasureReport.period | Date precision SHALL be at least to day ( YYYY-MM-DD ) : start.toString().length()>9 and end.toString().length()>9 |
Key Elements View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
MeasureReport | C | 0..* | MeasureReport | This is a risk adjustment data exchange MeasureReport. mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |
measurereport-category | S | 1..1 | (Complex) | What category is this measure report URL: http://hl7.org/fhir/StructureDefinition/measurereport-category |
url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/measurereport-category" | |
value[x] | 1..1 | CodeableConcept | Value of extension Binding: MeasureReportCategory (extensible) | |
coding | Σ | 1..1 | Coding | Code defined by a terminology system |
code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: ra |
payerCodingGapReportId | S | 0..1 | id | Payer generated coding gap report id URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-payerCodingGapReportId |
software | S | 0..* | Reference(CRMI Software System Device) | Extension URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem |
vendor | S | 0..1 | Reference(US Core Organization Profile) | Vendor information URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-reportingVendor |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
status | ?!SΣ | 1..1 | code | complete | pending | error Binding: MeasureReportStatus (required): The status of the measure report. |
type | SΣC | 1..1 | code | The type code is fixed to 'data-collection' for a risk adjustment data exchange measure report Binding: MeasureReportType (required): The type of the measure report. Fixed Value: data-collection |
measure | SΣ | 1..1 | canonical(Risk Adjustment Model Measure) | This references a measure that represents a risk adjustment model, such as CMS-HCC V24, CMS-HCC V28. |
subject | SΣ | 1..1 | Reference(US Core Patient Profile) | What individual(s) the report is for |
date | SΣ | 1..1 | dateTime | When the report was generated |
reporter | SΣ | 1..1 | Reference(US Core Organization Profile) | Organization that generated the MeasureReport |
period | SΣC | 1..1 | Period | Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) |
start | SΣC | 1..1 | dateTime | Starting time with inclusive boundary |
end | SΣC | 1..1 | dateTime | End time with inclusive boundary, if not ongoing |
improvementNotation | ?!Σ | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue. |
group | SC | 0..* | BackboneElement | Condition Category |
id | S | 1..1 | string | Unique id for inter-element referencing |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
code | SΣ | 0..1 | CodeableConcept | Condition Category (CC) code for a Risk Adjustment Model Binding: Sample CMS Hierarchical Condition Category (example) |
evaluatedResource | S | 0..* | Reference(Resource) | An evaluated resource in a risk adjusstment data exchange MeasureReport is any data Provider submits to Payer as clinical evaluation evidence, such as a Consolidated Clinical Document Architecture (C-CDA) document, enounters, and diagnoses. |
Slices for extension | Content/Rules for all slices | |||
groupReference | S | 0..* | string | This references the MeasureReport.group.id. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference |
Documentation for this format |
Path | Conformance | ValueSet / Code | URI |
MeasureReport.extension:measurereport-category.value[x] | extensible | MeasureReportCategoryhttp://hl7.org/fhir/ValueSet/measurereport-category | |
MeasureReport.status | required | MeasureReportStatushttp://hl7.org/fhir/ValueSet/measure-report-status|4.0.1 from the FHIR Standard | |
MeasureReport.type | required | Fixed Value: data-collectionhttp://hl7.org/fhir/ValueSet/measure-report-type|4.0.1 from the FHIR Standard | |
MeasureReport.improvementNotation | required | MeasureImprovementNotationhttp://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.1 from the FHIR Standard | |
MeasureReport.group.code | example | SampleCMSHCChttp://hl7.org/fhir/us/davinci-ra/ValueSet/sample-cmshcc from this IG |
Id | Grade | Path(s) | Details | Requirements |
dom-2 | error | MeasureReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
dom-3 | error | MeasureReport | 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 | error | MeasureReport | 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 | error | MeasureReport | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
dom-6 | best practice | MeasureReport | A resource should have narrative for robust management : text.`div`.exists() | |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
mrp-1 | error | MeasureReport | Measure Reports used for data collection SHALL NOT communicate group and score information : (type != 'data-collection') or group.exists().not() | |
mrp-2 | error | MeasureReport | Stratifiers SHALL be either a single criteria or a set of criteria components : group.stratifier.stratum.all(value.exists() xor component.exists()) | |
ra-1 | error | MeasureReport.period | Date precision SHALL be at least to day ( YYYY-MM-DD ) : start.toString().length()>9 and end.toString().length()>9 |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints | ||||
---|---|---|---|---|---|---|---|---|
MeasureReport | C | 0..* | MeasureReport | This is a risk adjustment data exchange MeasureReport. mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components | ||||
id | Σ | 0..1 | id | Logical id of this artifact | ||||
meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
contained | 0..* | Resource | Contained, inline Resources | |||||
Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
measurereport-category | S | 1..1 | (Complex) | What category is this measure report URL: http://hl7.org/fhir/StructureDefinition/measurereport-category | ||||
id | 0..1 | id | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/measurereport-category" | |||||
value[x] | 1..1 | CodeableConcept | Value of extension Binding: MeasureReportCategory (extensible) | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
coding | Σ | 1..1 | Coding | Code defined by a terminology system | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
system | Σ | 0..1 | uri | Identity of the terminology system | ||||
version | Σ | 0..1 | string | Version of the system - if relevant | ||||
code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: ra | ||||
display | Σ | 0..1 | string | Representation defined by the system | ||||
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
text | Σ | 0..1 | string | Plain text representation of the concept | ||||
payerCodingGapReportId | S | 0..1 | id | Payer generated coding gap report id URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-payerCodingGapReportId | ||||
software | S | 0..* | Reference(CRMI Software System Device) | Extension URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem | ||||
vendor | S | 0..1 | Reference(US Core Organization Profile) | Vendor information URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-reportingVendor | ||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
identifier | Σ | 0..* | Identifier | Additional identifier for the MeasureReport | ||||
status | ?!SΣ | 1..1 | code | complete | pending | error Binding: MeasureReportStatus (required): The status of the measure report. | ||||
type | SΣC | 1..1 | code | The type code is fixed to 'data-collection' for a risk adjustment data exchange measure report Binding: MeasureReportType (required): The type of the measure report. Fixed Value: data-collection | ||||
measure | SΣ | 1..1 | canonical(Risk Adjustment Model Measure) | This references a measure that represents a risk adjustment model, such as CMS-HCC V24, CMS-HCC V28. | ||||
subject | SΣ | 1..1 | Reference(US Core Patient Profile) | What individual(s) the report is for | ||||
date | SΣ | 1..1 | dateTime | When the report was generated | ||||
reporter | SΣ | 1..1 | Reference(US Core Organization Profile) | Organization that generated the MeasureReport | ||||
period | SΣC | 1..1 | Period | Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
start | SΣC | 1..1 | dateTime | Starting time with inclusive boundary | ||||
end | SΣC | 1..1 | dateTime | End time with inclusive boundary, if not ongoing | ||||
improvementNotation | ?!Σ | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue. | ||||
group | SC | 0..* | BackboneElement | Condition Category | ||||
id | S | 1..1 | string | Unique id for inter-element referencing | ||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
code | SΣ | 0..1 | CodeableConcept | Condition Category (CC) code for a Risk Adjustment Model Binding: Sample CMS Hierarchical Condition Category (example) | ||||
population | 0..* | BackboneElement | The populations in the group | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
code | Σ | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.). | ||||
count | 0..1 | integer | Size of the population | |||||
subjectResults | 0..1 | Reference(List) | For subject-list reports, the subject results in this population | |||||
measureScore | Σ | 0..1 | Quantity | What score this group achieved | ||||
stratifier | 0..* | BackboneElement | Stratification results | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
code | 0..* | CodeableConcept | What stratifier of the group | |||||
stratum | 0..* | BackboneElement | Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
value | 0..1 | CodeableConcept | The stratum value, e.g. male | |||||
component | 0..* | BackboneElement | Stratifier component values | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
code | 1..1 | CodeableConcept | What stratifier component of the group | |||||
value | 1..1 | CodeableConcept | The stratum component value, e.g. male | |||||
population | 0..* | BackboneElement | Population results in this stratum | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
code | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.). | |||||
count | 0..1 | integer | Size of the population | |||||
subjectResults | 0..1 | Reference(List) | For subject-list reports, the subject results in this population | |||||
measureScore | 0..1 | Quantity | What score this stratum achieved | |||||
evaluatedResource | S | 0..* | Reference(Resource) | An evaluated resource in a risk adjusstment data exchange MeasureReport is any data Provider submits to Payer as clinical evaluation evidence, such as a Consolidated Clinical Document Architecture (C-CDA) document, enounters, and diagnoses. | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
groupReference | S | 0..* | string | This references the MeasureReport.group.id. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference | ||||
reference | ΣC | 0..1 | string | Literal reference, Relative, internal or absolute URL | ||||
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | ||||
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | ||||
display | Σ | 0..1 | string | Text alternative for the resource | ||||
Documentation for this format |
Path | Conformance | ValueSet / Code | URI | |||
MeasureReport.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languages from the FHIR Standard | ||||
MeasureReport.extension:measurereport-category.value[x] | extensible | MeasureReportCategoryhttp://hl7.org/fhir/ValueSet/measurereport-category | ||||
MeasureReport.status | required | MeasureReportStatushttp://hl7.org/fhir/ValueSet/measure-report-status|4.0.1 from the FHIR Standard | ||||
MeasureReport.type | required | Fixed Value: data-collectionhttp://hl7.org/fhir/ValueSet/measure-report-type|4.0.1 from the FHIR Standard | ||||
MeasureReport.improvementNotation | required | MeasureImprovementNotationhttp://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.1 from the FHIR Standard | ||||
MeasureReport.group.code | example | SampleCMSHCChttp://hl7.org/fhir/us/davinci-ra/ValueSet/sample-cmshcc from this IG | ||||
MeasureReport.group.population.code | extensible | MeasurePopulationTypehttp://hl7.org/fhir/ValueSet/measure-population from the FHIR Standard | ||||
MeasureReport.group.stratifier.stratum.population.code | extensible | MeasurePopulationTypehttp://hl7.org/fhir/ValueSet/measure-population from the FHIR Standard | ||||
MeasureReport.evaluatedResource.type | extensible | ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard |
Id | Grade | Path(s) | Details | Requirements |
dom-2 | error | MeasureReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
dom-3 | error | MeasureReport | 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 | error | MeasureReport | 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 | error | MeasureReport | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
dom-6 | best practice | MeasureReport | A resource should have narrative for robust management : text.`div`.exists() | |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
mrp-1 | error | MeasureReport | Measure Reports used for data collection SHALL NOT communicate group and score information : (type != 'data-collection') or group.exists().not() | |
mrp-2 | error | MeasureReport | Stratifiers SHALL be either a single criteria or a set of criteria components : group.stratifier.stratum.all(value.exists() xor component.exists()) | |
ra-1 | error | MeasureReport.period | Date precision SHALL be at least to day ( YYYY-MM-DD ) : start.toString().length()>9 and end.toString().length()>9 |
This structure is derived from MeasureReport
Summary
Mandatory: 9 elements(1 nested mandatory element)
Must-Support: 18 elements
Fixed: 2 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Other representations of profile: CSV, Excel, Schematron